Start with the emergency physician

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

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

“Good!” Wu Guohui and He Jianyi also did not recommend being commanded by Zhou Yuan, and immediately began to debride.

Zhou Yuan looked at the two amputated limbs at the distal 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, and can only fight with the instrument nurse on the side.

The personnel for this amputation replantation operation are:

Main knife: Zhou Yuan.

Kazuke: He Jianyi.

Second assistant: Wu Guohui.

Sansuke: Ocean.

The villain Zhou Yuan is also He Jianyi’s student, and it is still no problem to mix with his own students. Although Wu Guohui also wanted to appreciate Zhou Yuan’s amputated limb replantation technique, he did not dare to compete with He Jian.

“Okay.” He Jianyi wanted to let the ocean learn more and reminded.

The ocean oh oh twice, quickly ran to He Jianyi, to observe carefully, almost scolded to death by He Jianyi.

“I’ll let you go and see Zhou Yuan’s operation! Roll over. ”

Ocean: “Oooh. ”

Zhou Yuan devoted himself to Qingdebridement, and did not care about the ocean behind him.

Debridement is the most basic technique in surgery, and the main point is to completely remove non-viable or contaminated tissue. There are two principles of operation: from the outside to the inside, from shallow to deep. This is to prevent omissions during debridement or aggravating contamination of deep tissues.

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

This is all about creating opportunities for later coincidence.

Ten minutes later, Zhou Yuan exposed the last blood vessel and stretched out his hand: “Flat head needle.” ”

Ocean recovered from the dazzling debridement operation and immediately presented the instrument.

Zhou Yuan sucked a tube of heparin solution, then inserted a flat-headed needle into the lumen of the artery, pressurized and flushed, and removed impurities such as residual blood clots in the severed limb. It is not until the heparin solution becomes colorless and transparent that Zhou Yuan stops rinsing.

“Well, the blood clot problem is perfectly solved.”

Zhou Yuan immediately began the cleaning of the second amputated limb.

The ocean had already looked at it, and after Zhou Yuan started the debridement of the second distant limb, the ocean directly approached the severed limb that Zhou Yuan had treated, picked up the microscope and carefully observed.

“It’s really God’s food…” After a long time, the ocean with the mentality of viewing art finally came to his senses and burst into tears.

Damn, why does someone even do debridement better than the textbook!

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

At this time, Zhou Yuan’s second distal limb and the first proximate limb of Wu Guohui and He Jianyi completed debridement at the same time.

Zhou Yuan ignored the shock on the faces of Wu Guohui and He Jianyi, and said with some solemnity: “The ulnar radial nerve, ulnar artery, radial artery and other major arteries on the patient’s hands have 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, just about to say that he could only consider amputation, Zhou Yuan did not give him a chance to answer, and continued: “This operation takes a long time, the task is arduous, let’s… Be sure to succeed! ”

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

“Go on, next is bone processing.” Zhou Yuan immediately began to move.

Skeletal treatment is an integral part of amputated limb replantation. Only by rebuilding bone continuity can the effect of replantation of amputated limbs be guaranteed.

Due to the resection and retraction of soft tissue, the bone grows accordingly, so it is necessary to remove the exposed bone end in the severed limb, which can both accommodate the shortening of the soft tissue and reduce the chance of infection and prevent osteomyelitis.

Even masterful amputated limb replantation techniques must be properly removed and trade-offs in the face of such complex amputated limbs. Although there is no guarantee of a return to the original level, normal life and work are not a major problem.

Zhou Yuan carefully cut the harmful exposed bones.

The scope of resection is based on the soft tissue contact of the two severed ends as the standard, as long as it can ensure that the blood vessels and nerves anastomosis without tension.

A few hours later.

“After the bone is processed, the next step is the treatment of the blood vessels.”

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

After Zhou Yuan anastomosed all the arteries and blood vessels, no matter how much, he directly restored the blood circulation of the severed limb.

This is for the sake of patients, only by re-circulating the blood of the severed limb as soon as possible can its vitality be guaranteed, and at the same time, the cells and toxic traits that are necrotic due to lack of oxygen and other reasons in the severed limb can be excreted from the body, reducing systemic adverse reactions after surgery.

Wu Guohui was dumbfounded on the sidelines.

“He Jianyi, I think…” Wu Guohui loved Cai.

In the hospital, surgery is much better than the emergency department, and the treatment is more than a little better.

Before Wu Guohui finished speaking, He Jianyi interrupted him: “Whoever robs with me, I am anxious with whom!” ”

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