Start with an emergency physician

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The order of selection depends on the patient's condition and the technical level of the surgeon.

Zhou Yuan glanced at the patient's heart rate and blood pressure, and said:"Amputation first."

Zhou Yuan learned a lesson from the previous mouse experiment that too low temperature can lead to complications such as vascular spasm. Once the toes are amputated and waiting for transplantation, the temperature of the toes will gradually drop.

Even if good activity is preserved, it will be troublesome to transplant at that time.

""Okay." Dean Fang said, standing nearby.

After he finished speaking, Dean Fang suddenly seemed to remember something and looked at Zhou Yuan with some worry:"Weren't you on night shift last night? You should have just finished work now. Can you hold on?……"

Zhou Yuan nodded.

He had just finished taking the drug and his energy was gone.���His physical strength has reached its peak, so completing a limb replantation surgery is no problem at all!

"General anesthesia."Zhou Yuan said.

The anesthesiologist nodded, checked the heart rate and blood pressure, and started anesthesia after confirming that the patient was in good health.

In general, the patient with the severed finger was relatively lucky.

Generally, people with this condition would fall into a coma or even suffer from hemorrhagic shock, but the factory probably had frequent accidents, so the emergency measures were very good, and the severed finger was well hemostatic, allowing him to make it to the hospital.

"The room temperature is controlled at around 25 degrees, and the relative humidity is around 50%."Zhou Yuan emphasized this.

At the same time, he looked at the surgical instruments.

Although this operation is still strictly a limb replantation, it is still somewhat different because it requires the regeneration of fingers. The instruments are also configured according to Zhou Yuan's needs.

Two sets of surgical micro-instruments, three conventional debridement kits, two curved and two straight tissue scissors, toothless short forceps, ant forceps...

While the anesthesiologist was anesthetizing the patient, the instrument nurse had already placed the surgical microscope.

"The anesthesia is taking effect. The anesthesiologist's voice sounded.

Zhou Yuan nodded.

"Open two intravenous channels immediately, replenish fluids in time, and perform infusions and blood transfusions throughout the operation. Plasma substitutes or whole blood can be used!"

""Put in a urinary catheter!"

The last step was not necessary for the operation, so when Zhou Yuan brought it up, everyone was a little confused.

The reason for putting in a urinary catheter was to observe the patient's physical changes.

Finger regeneration is not a small operation, and it takes more than ten hours. During this period, the patient's absorption of drugs and physical function can be judged based on the patient's urine volume, urine color, urine specific gravity, etc.

When the catheter entered the bladder and the orange-yellow color appeared, Zhou Yuan announced the start of the operation.

"Start cleaning and disinfection."

If it is just a simple amputation, it can be removed after a simple disinfection.

However, this time, the toe needs to be transplanted to the index finger and thumb. Therefore, the cross section must be carefully handled to ensure that the main nerves and blood vessels are fully exposed.

Otherwise, even the nerves and blood vessels cannot be found, so how can we talk about transplantation?

"Soapy water, hydrogen peroxide."

This is the cleaning solution used for cleaning.

Zhou Yuan turned the patient's palm over, so that the broken surface was facing down, and carefully washed it with soapy water and hydrogen peroxide.

After the debridement and disinfection were completed, Zhou Yuan began to perform debridement.

This step is mainly to completely remove the damaged severed finger, including the rotten tissue around the severed finger.

Of course, there may still be some blood vessels in the severed finger that can be used. At this time, the blood vessels need to be peeled out separately - long blood vessels are easy to expose, and it is easier to suture and anastomose.

""Tissue scissors."

Zhou Yuan's movements were very steady. He took the tissue scissors and cut the severed finger one by one.

There were many tiny blood vessels in the severed finger, most of which had been broken.

Zhou Yuan carefully marked the few blood vessels that were still intact and could be connected.

In addition, the axillary artery and the brachial artery anastomosed at the palm, forming a double layer of superficial palmar arch and deep palmar arch. Because the thumb and index finger were damaged, the blood flow needed to be clamped and the main artery here should be ligated. The superficial palmar arch and the deep palmar arch are two layers of arc-shaped vascular arches on the deep surface of the palm skin, both of which are convex to the distal end, that is, the fingertips.

Among them, the projection of the superficial palmar arch is basically the same as the"career line" in the palm print, and the deep palmar arch is closer to the wrist. There are abundant arterial communication branches between them, which is mainly to ensure that the hand can move smoothly during various movements. The palm will not be ischemic.

Therefore, when removing the remaining fingers, care must be taken not to damage the superficial palmar arch and the deep palmar arch, otherwise the recovery of the palm's motor ability will be greatly limited in the later period.

Then, Zhou Yuan found the main muscles such as the abductor pollicis brevis, flexor pollicis brevis, opponens pollicis, and flexor pollicis longus tendons.

These are the muscles that drive the thumb and index finger to complete movements such as bending and stretching. They must be connected to the muscles on the toes to drive the toes to move.

Zhou Yuan looked at the microscope and carefully removed the embolized blood vessels and damaged nerves on it, and repaired some smaller damaged arteries and veins as much as possible.

The more blood vessels that can function, the better the recovery ability of the transplanted and regenerated fingers. Of course, it also means that the transplanted fingers can perform more functions.

""Hold the needle forceps."

Zhou Yuan looked at the damaged blood vessels under the microscope and sutured them with the needle.

"Done."

After a long time, Zhou Yuan cut off the last piece of rotten flesh, exposing a major thumb artery, and marked it with silk thread.

At this time, the thumb and index finger on the patient's palm had been completely peeled off, and the hand bones were also severed from the human body.

""Zhou Yuan, leave these two fingers to me, you can amputate the toes next." Dean Fang ran up happily.

Zhou Yuan nodded.

As a master of hand surgery, it is no problem for him to take care of two severed finger sections.

"Prepare to amputate the toes."

Relatively speaking, this step is easier.

The blood vessels in the soles of the feet are tougher and more elastic than those in the palms of the hands. In addition to transmitting muscle movement and reflex movements, the nerves here are also responsible for monitoring whether muscle movement is excessive or inappropriate.

Because the feet are farthest from the heart and brain, they are one of the organs that are difficult for blood and nerve conduction to reach. Therefore, the blood vessels can contract according to the changes in the foot shape during walking, thereby promoting blood circulation, and the nerves here also carry more functions.

Zhou Yuan chose to amputate the second and fourth toes of his right foot.

Zhou Yuan also had his own reasons for choosing these two toes._To read the ununderlined version of the novel, please download Fulu Novel AP