Start as an Emergency Physician

"The Brief Psychiatric Rating Scale is a scale that assesses the degree of psychotic symptoms, do you want to test your body for 18 things right away?"

The corners of Zhou Yuan's mouth twitched: "Get out." "

System: "Do you listen to cross talk?"

Zhou Yuan's face darkened, "Be a person." "

As he spoke, he directly blocked the system and looked at Yang Yongxin.

Toe transplantation and rebuilding thumb are only done once, how dare you do it while listening to cross talk?

Moreover, this is not just an operation, the people around him are watching, Zhou Yuan will definitely teach.

"Can you start?" Wu Guohui was a little impatient.

Haiyang and the others also stared at Yang Yongxin on the operating table, eager to start cutting off his feet immediately.

Zhou Yuan nodded and picked up the scalpel.

"The first is the choice of the arteries in the receiving area..."

This step is not difficult for Zhou Yuan, it is just to expose the arteries of the upper limbs that need to be anastomized.

"The artery in the receiving area is anastomosed by the terminal branch of the ulnar artery and the superficial palmar branch of the radial artery to form a superficial palmar arch, and four common metacarmal arteries are issued from the arch flange, which travel distantly along the palmar space, and each common metacarmal artery is 1.25 cm away from the webbed to divide into two volar propria arteries, and the propral arteries are dissected, marked, and fixed..."

Zhou Yuan's tone was light and light, and the operation was also smooth.

Wu Guohui stared at Yang Yongxin's hand, and under Zhou Yuan's scalpel, Yang Yongxin's broken index finger and middle finger were quickly cleaned up.

Debridement, disinfection, exposure of blood vessels, etc., all in one go.

Wu Guohui was stunned, pushed Director Wang away, and leaned under the microscope to observe carefully.

"It's time to dock... Picked up?!"

"It's starting to show blood vessels... It's revealed?!"

"The stump has begun... Finished excising?!"

Director Wang's face darkened: "Can you not make a fuss?"

Wu Guohui stepped back from the microscope in shock, "Director Wang, take a look for yourself, Zhou Yuan has begun to dissect tendons." "

Director Wang smiled slightly.

It's up to me to see it.

He walked up and looked into the microscope, "... This is already dissected?!"

After about an hour, Zhou Yuan completed the treatment of the receiving area, that is, the hand.

Zhou Yuan looked at Yang Yongxin's toes again and said, "The next thing is the choice of the donor artery." "

"Marker pen. "

Zhou Yuan picked up the marker pen and drew a line according to his own judgment.

Avoid important blood vessels and hard-to-heal tissues to choose the best location for the opening.

This is the basic skill and the key to the outcome of the surgery.

A good opening position allows the patient to cause minimal damage on the one hand, and on the other hand, to provide the doctor with the most surgical field and better operating space.

Striking the right balance between the two is a must-have skill for a doctor.

"Alright. "

A few minutes later, Zhou Yuan drew lines along the new foot blood vessels.

These threads can be accompanied exactly around the blood vessels, which can minimize bleeding and heal quickly, but they place high demands on the technique of the main knife.

After all, if you are not careful, you will cut off the blood vessels next to you, and there are arteries in this place, and you may have blood rush at that time.

"The selection of donor arteries is complex. "

Zhou Yuan dropped the knife, cut the skin along the scribing line, and explained it while explaining.

"The first dorsal metatarsophalangeal artery extends to the first web, and two dorsal phalangeal arteries branch off near the metatarsophalangeal joint. These two dorsal digital arteries are located on the dorsum of the toes opposite to the second toe. Revealed. "

"At the webbed of the first toe, the two propria arteries on the opposite side of the second toe of the middle toe, which are mixed arteries, consisting of branches from the dorsal first metatarsal, 36% of which are branches from the common plantar artery of the first toe, and 19% of which are composed of two arterial branches. Revealed. "

"There is an anastomosis within the superficial fascia between the dorsal toe arteries on both sides, between the propria arteries of the plantar of the toes, and between the dorsum of the diges and the arteries propria of the plantar of the toes. Be careful when separating. "

Zhou Yuan said, using a scalpel to reveal the artery in his mouth while demonstrating how to achieve the best separation.

"I opted for a V-shaped incision. Zhou Yuan said.

Wu Guohui, Haiyang and others nodded.

By choosing the V incision, you are actually taking care of them.

If it's a more difficult incision method, I'm afraid my group won't be able to master it...

Zhou Yuan knew what they were thinking and explained, "The V incision is also beneficial. Conventional free second toe reconstruction thumb surgery, whether it is the removal of the toe or the preparation of the hand receiving area, is more traumatic. In particular, the toe can be cut through the entire foot with almost one incision. "

"This requires all the skin on the foot to be removed again, which can cause a lot of damage and take a lot of time. The V-shaped incision we chose was minimized by both the incision of the toe and the treatment of the receiving area. "

After more than an hour, the dissociation of the toes was also completed.

The next step is the transplantation and reengineering process.

This is the most critical step in toe transplantation and thumb reconstruction.

The cost and time of surgery are closely related to the number of blood vessels and nerves that need to be anastomized.

Yang Yongxin's hand condition is much better than that of Wang Dong before, so the operation time will be reduced a lot.

Of course, this means that the cost of surgery will also plummet.

Five hours later, Zhou Yuan completed the connection of the last blood vessel.

Wu Guohui: "That's... Done?"

Hikaru Morimoto: Koichi Si..."

Now Hikaru Morimoto has nothing to say at all.

He also began to understand why Zhou Yuan dared to carry out the reinvention finger project in the first place... Because Zhou Yuan's ability to replant severed limbs is too strong!

A few large arteries and veins are easy to say, even if you can figure it out by groping, but... What about vascular networks?

Zhou Yuan even the anastomosis of the vascular network is smooth...

"Seven hours, it's ok. Zhou Yuan relaxed a little.

"Director Wu, Director Wang, can you still hold on?"

Wu Guohui smiled: "I'm not at the point of being an old bone, right! And I'm just doing a favor, and I'm still standing firm!"

Director Wang also smiled and nodded.

Zhou Yuan was silent for a moment and said, "Can I hold on to what I said, meaning... Can you make another one?"

Toe transplantation and thumb reconstruction is not a minor operation, and the process requires the close cooperation of Wu Guohui, Director Wang and Haiyang.

"What?make another one?!"

Wu Guohui and Director Wang glanced at each other, and at the same time looked at Zhou Yuan: "This is crazy, one unit a day is already the limit!"

Zhou Yuan glanced at the time.

The operation started at 9 o'clock in the morning, and it is now 6 o'clock in the afternoon.

"You don't really want to do it continuously, do you?" Wu Guohui swallowed.

To be honest, he and Director Wang still persevered. It's just an assistant, and the physical exertion is not so terrifying.

Zhou Yuan shook his head: "Of course it won't be done continuously." "

Hearing this, Wu Guohui and the others were just about to breathe a sigh of relief, and Zhou Yuan said again: "I haven't eaten anything." Let's finish our meal and move on. "

“？？？"_

Feilu reminds you: there are three things to read - collection, recommendation, and points