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Zhang Peng
General Surgery
About me
Studied at Changzhi Medical College from 2004 to 2009, graduated with a bachelor's degree; Studied at Qinghai University from 2009 to 2012, graduated with a master's degree in surgery; Employed at Linfen People's Hospital in July 2012, working in general surgery to present. Visiting scholar at Peking University Medical School from March to December 2019.
Proficient in diseases
Common diseases in general surgery: comprehensive treatment of gastrointestinal tumors, thyroid and breast diseases, inguinal hernia, etc.
Voices
What are the circumstances in which a tetanus shot should not be administered?
Tetanus is a strict anaerobic bacterium. Clinically, for deeper contaminated wounds, especially those contaminated by soil or punctured by rusty iron objects, an active injection of tetanus vaccine is recommended. Generally, for superficial scratches or clean and shallow wounds, as long as proper wound cleaning is performed, it is usually not necessary to administer a tetanus shot. For patients who have completed a full course of immunization or booster immunization within the last ten years and have high antibody levels in the body, if the wound is small, superficial, and free of foreign bodies or necrotic tissue residue, it is not necessary to inject the tetanus vaccine. For wounds that are larger, deeper, and heavily contaminated, with substantial residues of foreign bodies and necrotic tissue, or in cases where thorough wound cleaning is not achievable, an enhanced injection of tetanus antitoxin or immunoglobulin should be administered.
How is umbilical hernia treated?
In treating umbilical hernias, we need to consider both the age of the patient and the size of the hernia specifically caused. Generally, children under the age of two do not require surgery. Typically, we consider using a coin or cardboard larger than the umbilical ring, wrapping it up, pressing against the umbilical ring, and securing it with adhesive tape to prevent movement. Most can close by themselves and heal. For children over two years old, if the hernia is still larger than 1.5cm, surgical treatment should be considered. In adults, traditional tissue repair methods are generally used, or an open umbilical hernia tension-free repair. The repair can be placed in front of the muscle or can use a hernia ring filling method. For most patients, if there is an opportunity for minimally invasive treatment, laparoscopic umbilical hernia repair can be selected. This method generally involves a smaller incision and can preserve the navel, reducing the chance of incision infection, and is particularly suitable for obese patients.
Will an umbilical hernia get bigger as it grows?
Umbilical hernias may increase in size, particularly in middle-aged, obese women who have been pregnant multiple times, have excessive fat in the greater omentum during pregnancy, or have chronic conditions such as persistent coughs, which can cause continuous increased pressure in the abdominal cavity. This may lead to the gradual enlargement of the hernia sac in an umbilical hernia, and it is very prone to becoming incarcerated. The contents of the incarceration might include the greater omentum or the intestines, particularly the small intestine. Once incarceration and strangulation occur, it is generally recommended that adults with umbilical hernias undergo surgery as soon as possible, with emergency surgical treatment needed in cases of incarceration. Traditional surgical methods include tissue suture repair or open umbilical hernia tension-free repair. If a minimally invasive option is available, it is generally less traumatic and particularly suitable for obese patients.
What should I do if I drink alcohol with tetanus?
If there are high risk factors for tetanus infection after an injury, and alcohol has been consumed, it is generally advisable to wait until sobriety before conducting relevant skin tests. Currently, there is no clear research on the relationship between alcohol consumption and an allergy to tetanus antitoxin. It is not very clear whether alcohol impacts the results of a skin test, so it is safer to perform the test after sobering up. Since the consequences of a tetanus infection can be severe, and the tetanus injection itself carries a certain risk of anaphylactic shock, which can lead to multiple organ problems and even be life-threatening, it is generally safer to conduct the skin test after sobering up and then proceed with the timely injection treatment. If the skin test is positive, tetanus immunoglobulin should be chosen promptly.
How come hemorrhoids bleed?
In this case, it depends on the cause of the hemorrhoids. In general, the most common cause of hemorrhoids is varicose veins around the rectal veins, which can be caused by obstructed venous return. Generally, there are no corresponding venous valves around the upper rectal veins, and the veins or small vein walls of hemorrhoids are very thin. In the case of hemorrhoidal venous varicose, if the stool is relatively dry, it is easy to cause the veins to rupture and bleed during defecation. This type of bleeding is generally painless, and the bleeding can stop on its own, usually being bright red blood. Due to high local pressure, some people may experience significant bleeding, or even show signs of shock. In this case, surgical treatment measures must be taken to achieve radical cure.
Can an umbilical hernia heal itself?
Umbilical hernia has the potential to heal on its own, but it requires conservative treatment methods to be adopted. Generally, children under the age of two can undergo conservative observational treatment, such as using adhesive tape, as the umbilical ring in most cases can close by itself between the ages of 1 and 2. However, if the child is over two years old and the diameter of the umbilical ring still exceeds 1.5 cm, choosing surgical treatment is a wise decision. For patients over the age of five, it is recommended to undergo surgery as early as possible regardless of the situation, as the chances of incarceration or strangulation can increase after the age of five. Generally, surgical intervention is required for a cure. Options include traditional tissue suture repair methods or open umbilical hernia tension-free repair.
Can lipomas disappear?
Lipomas generally do not disappear on their own, and currently the only effective treatment for subcutaneous lipomas is surgical removal. However, lipomas are typically managed with an observational approach in clinical settings. Regular ultrasound checks can be scheduled to assess the growth rate of the lipoma and monitor any clinical symptoms it may cause. Observation is mainly employed because lipomas rarely turn malignant and because lipomas, especially those on the body's surface, often appear as multiple lesions. Complete removal can lead to surgical scars, affecting the appearance. Most lipomas grow slowly, often remaining asymptomatic under one centimeter, requiring no special treatment. During follow-up, if the growth rate is unusually rapid, malignancy cannot be ruled out, and surgical removal should be considered.
Symptoms of Tetanus
What are the symptoms of tetanus? Generally, the prodromal symptoms include overall weakness, headache, difficulty swallowing, or limited movement of the head and neck. If the condition progresses further, there may be typical symptoms such as difficulty opening the mouth or tense jaw muscles, leading to muscle spasms in the limbs, possibly causing spasms of the larynx, which can lead to breathing difficulties or even suffocation. Hence, it is a particularly severe manifestation. Some individuals may experience generalized tonic muscle spasms throughout the body, a milder manifestation with a typically longer incubation period. Therefore, in the treatment of tetanus, proactive active immunization should be pursued.
Symptoms of intestinal obstruction
For symptoms of intestinal obstruction, the typical manifestations are abdominal pain, bloating, vomiting, and cessation of passing gas or stool. Most people may experience several of these symptoms; however, the severity of the symptoms depends on the location and condition of the obstruction. Once symptoms of intestinal obstruction occur, it is necessary to refrain from eating and then carry out appropriate examinations. Identifying the cause of the obstruction is crucial. If the obstruction is caused by tumor-related factors, surgical treatment should be considered based on a comprehensive assessment. If the obstruction is due to adhesions, conservative treatment methods should be adopted where possible.
How long does the tetanus shot last?
The duration of the effectiveness of a tetanus shot depends on whether tetanus antitoxin or tetanus immunoglobulin is administered following a suspected tetanus infection. Both types are forms of artificial passive immunity, providing immediate specific immunity after injection, mainly for treatment or emergency prevention. The metabolism and immune duration of these two injections vary: generally, tetanus antitoxin lasts about seven days, while tetanus immunoglobulin can last up to three weeks. Therefore, the specific duration of the effectiveness of a tetanus shot must be determined based on the individual injection circumstances. For suspected tetanus infections, it is generally advised to administer the injection as soon as possible. It's not that the injection will be ineffective if administered after a certain time, but rather that effective prevention before the onset of the disease can still be beneficial.