Knight Story: Learning medicine can’t save the world!

Chapter 70 The operation went to the dog!!

But fortunately, the tourniquet and gauze wrapped in the fracture were removed, and there was only a slight bleeding and dripping of blood.

“One piece of venom hemocoagulase for white-browed snake, intramuscular injection!”

“Director Takano, you will debride the patient’s severed limb.”

“Director Morita, you are an expert in debridement of amputated limbs, and the wounds on the patient’s body will trouble you. ~” Lin Yu said.

Hideki Takano and Daika Morita also did not talk nonsense and began their respective work.

Hideki Takano first carefully washed the entire severed limb with sterile soapy water and a brush, and any were rinsed again with isotonic saline.

After doing this, Hideki Takano, with the help of Jimura Danzo, added a new pair of gloves, washed the edges of the wound with another set of sterile brushes and soapy water, and carefully brushed off the bone debris and debris on the wound with the brush.

After confirming that the severed limb was clean, Hideki Takano turned to another instrument table and mixed it with 3% iodine and 75% ether into a disinfectant, and once again fully disinfected the amputated limb.

After disinfection, Hideki Takano took the scalpel from Shizuka Kumagawa’s hand and removed the devitalized and contaminated muscle tissue and blood vessels and nerves from shallow to deep, as well as the incompletely free bone pieces.

The last step is also the most important step in debridement.

Flush the vascular bed!

The flushing of the vascular bed has three goals: first, whether the integrity of the vascular bed of the severed limb has been compromised in order to decide whether replantation surgery can be performed.

Second, it can flush out some toxic metabolites accumulated in tissues and clots in small blood vessels, reduce the body’s absorption of toxic substances, and provide a smooth vascular bed to lay a good foundation for rebuilding blood circulation.

Third, it can expand spasm, close small blood vessels and capillary networks, restore the siphon effect of capillaries, and help improve microcirculation in the future.

“The blood vessels, nerves, and veins of the severed limb wound are complete, the shoulder blade injury can be repaired, and the broken range at the humerus port is about one centimeter, and replantation surgery can be performed!”

After the comprehensive debridement was completed, Hideki Takano spoke.

At the same time, the debridement work on Morita’s side was also over.

“The blood vessels of the severed limb are complete, the meridians are complete, there is slight deformation, the deformation range is within two centimeters, and the broken range at the consolidation fracture is about one centimeter, which is within the acceptable range.”

“The only difficulty is that the median nerve and ulnar nerve are severely deformed, visually more than four centimeters, and completely unable to connect!”

Morita’s words made the atmosphere in the operating room instantly solemn.

The median nerve is lost in the axilla, a vein nerve formed by the lateral and medial tracts of the brachial plexus.

Walk along the biceps brachii in the arm, descend to the elbow fossa, and run between the biceps rounded brachii before pronation, between the shallow middle finger of the forearm, between the deep flexors to the carpal tunnel, through the deep surface of the palmar aponeurosis to the palm, and divide into several common palmar nerves.

The median nerve can involve all branches in the case of arm injury!

Manifested as forearm can not pronate, wrist weakness, thumb can not flex, thumb can not palm, fish muscle atrophy, palm flat, called ape hand!

In addition to this, vasoconstriction and nutritional disorders can occur.

The ulnar nerve arises from the medial tract of the brachial plexus and contains fibers of the seventh and eighth tibial nerves and the first thoracic nerve.

At the beginning with the brachial artery, and then leaving the brachial artery posteriorly down, to the ulnar nerve sulcus in the upper and posterior medial, the ulnar nerve position in the sulcus is superficial, the septal skin can be touched when the ulnar nerve is injured in the arm, mainly manifested as weakened wrist flexion ability, flexion of the distal phalanges of the fourth and fifth fingers can not be flexed and the thumb adduction is weak, the small fish bone and interosseous muscles are obviously atrophied, the fingers can not get closer to each other, the metacarpophalangeal joints are hyperextended, and the interphalangeal joints of the fourth and fifth fingers are bent, which is called “claw-shaped hand!” ”

To put it simply, if there is a problem with the median nerve and ulnar nerve, even if the arm is successfully replanted, it can only be a decoration!

“What now?”

The director of the orthopedic department said with a gloomy face.

“The median nerve and the ulnar nerve are the two main nerves of the arm! If these two nerves cannot be connected, the entire arm will lose all functions! ”

“So what to do? Can’t this surgery be done? ”

The heads of other departments said.

“Now we can only tear down the eastern wall and make up for the western wall.”

Lin Yu’s words were like a bolt of lightning, shocking people and letting everyone see the dawn at the same time.

“Yes! You can also remove a median nerve and an ulnar nerve from somewhere else to make up for it! ”

“My God, I’ve had all the decades of surgery on dogs!”

Morita’s words made the atmosphere in the operating room a little strange.

Fortunately, most of the people here are doctors, and the only outsiders have been anesthetized.

Otherwise, he would definitely not have an arm, and he would have to fight hard with Morita.

What surgery has been done to dogs?

Who do you say is a dog!

Of course, this is just a joke, compared to Morita Dakong is scolding himself, governing the country and talking without brains.

“This is the only way, are you going to remove the median nerve and ulnar nerve there?”

Hideki Takano asked.

“Feet!”

Lin Yu replied calmly.

“Yes, yes, yes!”

“The soles of the feet are a good way, anyway, whether the toes can be bent or not, it doesn’t matter much!”

“Doctor Lin, it’s still you! Change to me, I can’t think of this method if I want to break my head! ”

“Sure enough, you were born to do neurosurgery! Would you like to consider coming to our department? In less than a year, I can definitely make you the administrative director of our neurosurgery! ”

Jimura Tuanzo said with a look of excitement.

“Hey, you’re enough, don’t forget to dig people for surgery!”

Hideki Takano said half-true and half-fake.

“Hehe, I can’t help it!”

Jimura Danzo smiled awkwardly.

The words of the Dimura Tuanzang made Lin Yu bristle.

If this is a woman is better, an old man of fifty or sixty years old, can’t you help but be suitable?

The directors of the remaining two departments stared directly at Lin Yu, and their eyes changed slightly.

“Since you have a way to solve the nerve matter, I will start instilling.”

Morita Daikura is also a man of action, not a word of nonsense.

“Trouble Director Morita.”

Lin Yu said lightly.

In fact, these programs Lin Yu can do, and they are no worse than Morita Dakong them.

But Lin Yu didn’t want to expose too much now.