Start as an Emergency Physician

"Teacher, Director Wu, please deal with the two amputated limbs at the proximal end. "

On the operating table, time is of the essence, and even if Zhou Yuan has a master-level amputated limb replantation technique, it is impossible to delay time.

"Okay!" Wu Guohui and He Jianyi also did not recommend being commanded by Zhou Yuan, and immediately began debridement.

Zhou Yuan looked at the two amputated limbs at the far end.

Although Haiyang is good at surgery, he definitely does not have enough experience in the fourth-level surgery of amputated limb replantation, which only the deputy chief physician is qualified to perform, so he can only work with the instrument nurse next to him.

The personnel of this amputated limb replantation surgery are:

Main knife: Zhou Yuan.

One help: He Jianyi.

Second assistant: Wu Guohui.

Sansuke: Ocean.

Anyway, Zhou Yuan is also a student of He Jianyi, and it is no problem to mix up a help under his own students. Although Wu Guohui also wanted to appreciate Zhou Yuan's amputated limb replantation technology, he didn't dare to grab it from He Jian.

"Look at it. He Jianyi wanted to let the ocean learn more, and reminded.

The ocean oh oh oh twice, and hurriedly ran to He Jianyi's side, just to observe carefully, and was almost scolded to death by He Jianyi.

"I'll let you go and see Zhou Yuan's operation! "

Ocean: "Uh-oh. "

Zhou Yuan devoted himself to debridement, and he didn't have the heart to care about the ocean behind him.

Debridement is the most basic surgical skill and involves the complete removal of non-viable or contaminated tissue. There are two principles of specific operation: from the outside in, from the shallow to the deep. This is to prevent omissions during debridement or aggravated contamination during the repair of deep tissues.

Zhou Yuan carefully cleaned up the severed limbs, marking the blood vessels with black ribbons from time to time, and in some inconvenient places, Zhou Yuan directly cut the skin and the fascia of the inner layer along the longitudinal axis of the limbs, exposing the blood vessels.

It's all about creating opportunities for the anastomosis that follows.

Ten minutes later, Zhou Yuan exposed the last blood vessel, stretched out his hand and said, "Flat-headed needle." "

Ocean came back from the dazzling debridement and immediately presented the instrument.

Zhou Yuan inhaled a tube of heparin solution, then inserted a flat-tipped needle into the lumen of the artery, and applied pressure irrigation to remove impurities such as residual blood clots in the severed limb. It was not until the heparin solution became colorless and transparent that Zhou Yuan stopped rinsing.

"Well, the thrombosis problem is perfectly solved. "

Zhou Yuan immediately began to clean the second amputated limb.

Haiyang had already looked at it, and after Zhou Yuan started the debridement of the second distal limb, Haiyang directly approached the severed limb that Zhou Yuan had handled, picked up the microscope and observed it carefully.

"It's really God's appreciation to eat..."After a long time, the ocean with the mentality of appreciating artworks finally came back to his senses and burst into tears.

Damn, why does anyone even do debridement better than textbooks!

This most basic skill is something that everyone knows, but it's the most difficult to do well.

At this time, Zhou Yuan's second distal limb and Wu Guohui and He Jianyi's first proximal limb were debrided at the same time.

Zhou Yuan ignored the shock on the faces of Wu Guohui and He Jianyi, and said with some solemnity: "The main arteries such as the ulnar-radial, ulnar, and radial arteries in the patient's hand are all ruptured, and the brachial plexus and blood vessels are damaged to varying degrees, and the situation is very bad. "

Wu Guohui was silent for a second, and was about to say that he could only consider amputation, but Zhou Yuan did not give him a chance to answer, and continued: "This operation takes a long time and the task is arduous, let... It must be successful!".

Wu Guohui was stunned, unable to believe what an intern doctor said.

"Moving on, the next step is bone processing. Zhou Yuan immediately started to move.

Bone treatment is an integral part of amputated limb replantation. Only by reconstructing the continuity of the bones can the effect of amputated limb replantation be guaranteed.

As the bone grows accordingly due to the excision and retraction of the soft tissues, it is necessary to remove the exposed ends of the severed limbs, which can accommodate the shortening of the soft tissues and reduce the chance of infection and prevent the development of osteomyelitis.

Even with the masterful amputated limb replantation technique, such a complex amputated limb must be appropriately excised and trade-off. Although there is no guarantee of a return to the original level, normal life and work are not a problem.

Zhou Yuan carefully cut the harmful exposed bones.

The scope of resection is based on the soft tissue contact at the dissection end, as long as the blood vessels and nerves can be anastomosed without tension, it is sufficient.

A few hours later.

"After the bones are processed, the next step is the blood vessels. "

After the skeletal continuity is established, the next round is the anastomosis and suturing of blood vessels, which is what Zhou Yuan is good at.

After Zhou Yuan anastomosed all the arteries and blood vessels, no matter how many there were, he directly restored blood circulation to the severed limb.

This is for the sake of the patient, only by recirculating the blood of the severed limb as soon as possible can the vitality of the severed limb be ensured, and at the same time, the necrotic cells and toxic substances in the severed limb due to lack of oxygen and other reasons can be excreted from the body, and the systemic adverse reactions after surgery can be reduced.

Wu Guohui was stunned from the sidelines.

"He Jianyi, I think..." Wu Guohui has a heart of love for talents.

In hospitals, surgery is much more popular than emergency departments, and the treatment is more than a little better.

Before Wu Guohui could finish speaking, He Jianyi interrupted him: "Whoever robs me, I am in a hurry!"

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