Start From Emergency Doctor

Chapter 18

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

On the operating table, time is life. Even with Zhou Yuan’s master-level technique for replantation of severed limbs, it is impossible to delay time.

“Okay!” Wu Guohui and He Jianyi did not recommend being directed by Zhou Yuan, and immediately began debridement.

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

Although the ocean is good at surgery, it is definitely not enough experience for replantation of severed limbs, a fourth-level surgery that only the deputy chief physician is qualified to perform. He can only fight with the instrument nurse by the side.

The personnel involved in the replantation of the severed limb are:

Chief Sword: Zhou Yuan.

One help: He Jianyi.

Second help: Wu Guohui.

Misuke: Ocean.

Anyway, Zhou Yuan is also a student of He Jianyi, so it’s okay to be a helper under his own students. Although Wu Guohui wanted to appreciate Zhou Yuan’s amputated limb replantation technique, he did not dare to compete with He Jian.

“I’m optimistic.” He Jianyi reminded that he wanted the ocean to learn more.

Ocean oh oh two times, hurried to the side of He Jianyi, he had to observe carefully, and he was almost scolded to death by He Jian.

“I want you to watch Zhou Yuan’s operation! Get out.”

Ocean: “Oh oh.”

Zhou Yuan devoted himself to the debridement, and didn’t care about the ocean behind.

Debridement is the most basic skill in surgery. The main point is to completely remove inactive or contaminated tissue. There are two specific operating principles: from outside to inside, from shallow to deep. This is to prevent omissions in the debridement process, or aggravated contamination in the repair of deep tissues.

Zhou Yuan carefully cleaned up the broken limbs, marking the blood vessels with black ribbons from time to time. In some inconvenient suturing places, Zhou Yuan directly incised the skin and inner fascia along the longitudinal axis of the limbs, exposing the blood vessels.(Read more @ wuxiax.com)

This is to create opportunities for the subsequent anastomosis.

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

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

Zhou Yuan inhaled a tube of heparin solution, then inserted a flat needle into the arterial lumen and flushed under pressure to remove residual blood clots and other impurities in the severed limb. Zhou Yuan did not stop washing until the heparin solution became colorless and transparent.

“Okay, the thrombosis problem is solved perfectly.”

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

The ocean has been seen once, and after Zhou Yuan started the debridement of the second distal limb, the ocean directly moved in front of the severed limb that Zhou Yuan had processed, and took a microscope to observe it carefully.

“It’s really good for me to enjoy food…” After a long time, the ocean of art-watching mentality finally recovered, tears streaming down my face.

Damn, why do some people even do debridement better than textbooks!

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

At this time, Zhou Yuan’s second distal limb was debrided at the same time as the first proximal limbs of Wu Guohui and He Jianyi.

Zhou Yuan ignored the shock on Wu Guohui and He Jianyi’s faces, and said solemnly: “The main arteries such as the radial ulnar nerve, ulnar artery, and radial artery on the patient’s hand were all ruptured, and the brachial plexus nerve and blood vessels were all affected to varying degrees. The situation is very bad.”

Wu Guohui was silent for a second. As soon as he was about to say that it was impossible, he could only consider amputation. Zhou Yuan did not give him a chance to answer, and continued: “This operation takes a long time and the task is arduous. We…must succeed!”

Wu Guohui was taken aback and couldn’t believe that this was what an intern said.

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

Bone treatment is a necessary part of replantation of severed limbs. Only by rebuilding the continuity of the bones can the effect of replantation of the severed limb be guaranteed.

Due to the removal and retraction of soft tissues, the bones will grow accordingly. Therefore, it is necessary to remove the exposed bone ends of the severed limbs. This can adapt to the shortening of soft tissues, reduce the chance of infection, and prevent osteomyelitis.

Even with the master-level replantation technique of severed limbs, in the face of such complicated severed limbs, appropriate excision and selection must be made. Although it is not guaranteed to return to the original level, there are no major problems with normal life and work.

Zhou Yuan carefully cut the harmful exposed bones.

The scope of resection is based on the contact between the soft tissues of the two stumps, as long as the blood vessels and nerves can be anastomosed without tension.

A few hours later.

“The bones are processed, and then the blood vessels are processed.”

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

After Zhou Yuan had anastomosed all the arteries and blood vessels, no matter too much, he directly restored the blood circulation to 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 ensured. At the same time, the necrotic cells and toxic substances in the severed limb can be discharged from the body due to hypoxia and other reasons, and the systemic adverse reactions after the operation can be reduced. .

Wu Guohui stayed aside and watched.

“He Jianyi, I think…” Wu Guohui had a passion for talent.

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

Before Wu Guohui could finish speaking, He Jianyi interrupted him: “Whoever robs me, who I am in anxious!”

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