Start as an Emergency Physician

Zhou Yuan nodded slowly and looked at the unknown son at the gate.

Indeed, what is the use of knowing the anastomosis method?

Toe transplantation to reconstruct the thumb, in the final analysis, the biggest difficulty is still the technology. That's why Zhou Yuan can do it, but Dean Fang, who participated in the entire operation, can't do it.

The master-level amputated limb replantation technique, I'm afraid there are only a few people present...

Kamihara Jing must be one, but he never wants to touch a scalpel in his life.

There are also John Joe and Richard, who should also be masters.

As for others, such as the Gate Unknown, it should be around the expert level.

The gate did not know the son, and said puzzledly: "The diameter of the plantar vein is very small, and there are many smaller branches, which is very difficult to operate even under a microscope. In the case of free metatarsal veins, only a small dorsal digital vein joins the dorsal metatarsal vein, which may cause postoperative reflux disorders. How can this problem be solved?"

Zhou Yuan pondered for two seconds.

Actually, it's a technical problem... It's a bit challenging for Zhou Yuan, but it's not a problem, anyway, he just needs to get started and match.

One force to break ten will be the same here as it is applicable... But others can't, and they can only rely on skill.

Fortunately, Zhou Yuan had already taken this into account when he was perfecting.

"In this case, when performing the separation, pay special attention to the abdomen of the toes, where one or two very thick veins of the toes can be found, which are free proximally, and the veins will flow along the sides of the toes into the dorsal metatarsal vein, so as to prevent only small blood vessels from entering the dorsal metatarsal vein, thus ensuring adequate venous return. "

According to this method, Dean Fang, whose skills are not up to the requirements, can also do it with the help of skills.

The gate was stunned, and after a few seconds, he sat down with a look of surprise on his face.

Shen Yuan Jing also had a different color on his face - he was thinking about this technical problem just now, and before he could come up with a sign, Zhou Yuan had already solved it.

"I have a question too—" John Joe stood up.

All of a sudden, people's eyes focused on John Joe.

At the meetings of the International Association for Hand Surgery, John Joe is a frequent figure, many people are familiar with him, and they are also aware of John Joe's status and ability in this field...

Now he also doesn't understand something.

However, the attention was not on John Joe's doubts, but because of what questions he was asking.

When faced with a new field, even the founders have questions... bar.

Everyone looked at the stage and was calm.

So far, Zhou Yuan has not been stumped by any problems, and the guy has really fully mastered the technique of reconstructing fingers!

"Professor John, you ask. Zhou Yuan smiled.

John Joe's face froze.

I'm a foreigner and my last name is at the back, shouldn't I be called Professor Joe?

However, he didn't care about these details, stood up, and said: "What should I do when the first dorsal metatarsal artery is missing or the diameter is too thin, or the second toe tibial dorsal digital artery is too thin and its blood supply cannot ensure the survival of the reconstructed finger after surgery?"

It's a question that can easily arise... Technically.

When performing toe resection, it is possible that too little is removed, resulting in insufficient length of the dorsal digital artery, or there may be errors in the treatment, or the patient's own physiological characteristics, resulting in vasospasm of the blood vessels, resulting in too thin pipe diameter.

These can lead to obstruction of blood circulation, insufficient blood supply, and inability to support the survival of regenerated fingers.

Zhou Yuan smiled, didn't bother to ponder for two seconds, and replied directly: "There are two ways to deal with it. "

"First, the propria artery of the tibial digital aspect of the second toe continues to be free from the propria artery of the toe-fibone-peroneal toe, and the length is cut as needed, so as to ensure that the length of the blood vessel is appropriate when the blood vessel is intercepted. Or directly use the double propina arteries, all the interception length errors, and then intercept one artery to form a double arterial system to supply blood. "

"In the second method, the propria propria artery of the tibial toe of the second toe continues to the common plantar artery of the first toe, and generally only the communication branch between the two arteries needs to be freed. Alternatively, you can choose to apply the intervascular communication branch, which is similar to the double proprinic artery above, but here is the communication branch, which is more complex and has a higher fault tolerance. "

John Joe's face was full of confusion: "Aren't these four ways?"

Zhou Yuan frowned, "The latter method is a remedy that the previous method has also missed, under normal circumstances, the application of the two methods of double intrinsic artery and intervascular communication is not recommended, because although it is simple, it is very complicated and the operation is cumbersome." "

Zhou Yuan can directly anastomosis the two blood vessels needed, while the double proprinis artery and the communication branch are both anastomoses of multiple blood vessels, although the difficulty is reduced, but it is a lot of trouble.

The venue fell silent, and everyone was thinking about the operability of the method in Zhou Yuan's mouth.

Only a few people's eyes lit up immediately.

"Why did you choose the V and S-shaped incisions for the dorsum incision of the foot, when I operated with you, you chose the annular and S-row incisions..."

Zhou Yuan was stunned for a moment, but he didn't expect Dean Fang to remember this detail.

The people around also looked at it.

There are also many people who have questions about the choice of incision, but ... A most basic incision, no one is embarrassed to ask!

They are all big people with heads and faces, and they actually ask people how to choose the incision, and no one dares to open this opening.

Zhou Yuan smiled, swept through everyone, and saw everyone's thoughts, and explained: "Actually, it is better to choose annular and S-shaped incisions, so that the blood vessels can be better peeled, but... Technically, the annular incision is more difficult, and if it is not operated well, it is easy to leave a wide range of wounds. "

"The reason why the V-shaped and S-shaped incisions were chosen is because the design of the V-skin flap makes it easier to perform the anastomosis of finger and toe wounds, and once tissue hematoma, vascular infection, etc. occurs after surgery, because the V-shaped incision is not so tightly anastomosed, it can buffer the pressure of the skin blood vessels and reduce the occurrence of potential vascular crisis caused by postoperative swelling. "

Annular incisions are faster and better adjunctive to vascular dissection. Zhou Yuan had the courage to choose the annular incision because he was sure to prevent the occurrence of tissue hematoma after surgery, and he did not need a V-shaped incision to cushion it, nor did he use its easier suturing feature.

But, for others, it is definitely the V incision that is more suitable.

Dean Fang silently hugged Chu Chu.

It's scary...

Zhou Yuan's technique has reached the point where he does not need to rely on skill at all.

No wonder his title says Toe Transplant Reconstructive Thumb Perfect!

During this time, he has transformed the reconstructed finger surgery that only Zhou Yuan can do alone, and through countless skills and tricks, into a practical surgery that other people can also try!_

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