Start From Emergency Doctor

Chapter 269

Zhou Yuan nodded slowly, and looked at the door unknown.

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

Toe transplantation to reconstruct the thumb, in the final analysis, the biggest difficulty is the technology. This is why Zhou Yuan can do it, but the director Fang who participated in the entire operation is not competent.

With the master-level replantation technique of severed limbs, there are probably only a few people present…

Shen Yuan Jing must be one, but in his whole life-don’t even want to touch the scalpel.

And John Joe, Richard, should-also be masters.

As for other people, such as Damen Unknown, they should be around the expert level.

Damen Mikiko frowned and said in a puzzled way: “The diameter of the plantar vein is very small, and there are many smaller branches. This is very difficult even under a microscope. When the plantar vein is freed, it will When only a very small dorsal toe vein merges into the dorsal plantar vein, it may cause postoperative reflux disorder. How to solve this problem?”

Zhou Yuan pondered for two seconds.

Actually, this is a technical problem… It’s a bit challenging for Zhou Yuan, but it’s not a problem. Anyway, he can just start the anastomosis directly.

Breaking ten guilds with a single force is also applicable here… but other people can’t do it, and can only rely on skill.

Fortunately, Zhou Yuan took this into consideration when making improvements.

“In this case, pay special attention to the abdomen of the toe during the separation. Here you can find one or two very thick veins of the toe, which will move proximally along the veins, and the veins will follow the toes. Both sides enter the dorsal plantar vein, which prevents only small blood vessels from entering the dorsal plantar vein, thus ensuring adequate venous return.”

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

The door unknown son was startled, a few seconds later, he sat down with a surprise expression on his face.

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

“I have a question too…” John Joe stood up.

All of a sudden, people’s eyes condensed on John Joe.

At the conferences of the International Hand Surgery Association, John Joe is a figure that frequently appears. Many people are familiar with him, and they are also aware of John Joe’s status and ability in this field…

Now he also has some things he doesn’t understand.

However, everyone is paying attention to John Joe not because he is surprised, but because he is curious about the question he asked.

Facing a new field, even founders will have questions… right.(Read more @ wuxiax.com)

Everyone looked at Zhou Yuan, who was calm and relaxed on the stage.

So far, Zhou Yuan has not been embarrassed by any problems. This guy has not really mastered the finger reconstruction technique completely!

“Professor John, please ask.” Zhou Yuan smiled.

John Joe’s face froze.

I am a foreigner and my last name is at the back. Shouldn’t I call me Professor Joe?

However, he did not care about these details, stood up, and said: “When the first dorsal metatarsal artery is missing or the diameter is too small, or the second toe tibial dorsal digital artery is too thin, the blood supply cannot guarantee the reconstruction of the finger after surgery. What should I do when I survive?”

This is a very easy problem… technically.

During toe resection, there may be too little resection, resulting in insufficient length of the dorsal toe artery, or mistakes in the treatment, the patient’s own physiological characteristics, resulting in vasospasm in the blood vessels, resulting in the diameter of the tube being too thin.

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

Zhou Yuan laughed, and was too lazy to indulge in two seconds of brewing, and directly replied: “There are two ways to deal with it.”

“The first one is to follow the proper arteries on the tibial side of the second toe to the proper arteries on the fibular side of the second toe, and cut the length as needed to ensure that the length of the blood vessel is appropriate. Or use the double proper arteries directly. Intercept the length of the error, and then intercept an artery to form a dual-arterial system to supply blood.”

“The second method is to follow the proper arteries on the tibial side of the second toe to the common plantar artery of the first toe. Generally, it is only necessary to free the communicating branches between the two arteries. . Or, you can choose to apply the inter-vascular communication branch, the method is similar to the above bi-proper arteries, but here is the communication branch, which is more complicated and has a higher fault tolerance rate.”

John Joe looked dumbfounded: “Aren’t these four ways?”

Zhou Yuan frowned, “The latter method is the remedy that the previous method has failed. Generally, the dual intrinsic arteries and intervascular communication branches are not recommended for application, because although simple, it is very complicated and the operation It’s also cumbersome.”

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Zhou Yuan can directly anastomose the two blood vessels that need to be anastomosed, and the bipropria arteries and communicating branches are anastomoses of multiple blood vessels. Although the difficulty is reduced, it is a lot of trouble.

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

Only a few people’s eyes lit up immediately.

“Why do you choose V-shaped and S-shaped incisions for the back of the foot? When I and you operated on, you chose circular and S-line incisions…” Dean Fang also raised questions at this time.

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

The people around also looked over.

Many people have questions about the choice of incision, but…the most basic incision, no one is embarrassed to ask!

……… ……… …….

They were all well-known big people, and they even asked people how to choose incisions. No one dared to open this mouth.

Zhou Yuan smiled, scanned the crowd, and saw what everyone was thinking, and explained: “Actually, it is better to choose a circular and S-shaped incision, so that the blood vessels can be peeled off better, but… technically, circular The incision is more difficult, and if it is not operated well, it is easy to leave a wide range of trauma.”

“The reason why the V-shaped and S-shaped incisions are chosen is that the design of the V-shaped skin flap makes it easier to anastomize the wounds of the fingers and toes. Moreover, once tissue hematomas, vascular infections, etc. occur after the operation, due to the V-shaped incision If the anastomosis is not so tight, it can cushion the pressure on the blood vessels of the skin and reduce the potential vascular crisis caused by postoperative swelling.”

The circular incision is faster and has a better assisting effect on vascular dissection. Zhou Yuan has the courage to choose the circular incision because he is sure to prevent tissue hematoma after the operation. It does not need a V-shaped incision to cushion, and it does not require its easier suture feature.

However, for others, a V-shaped incision is definitely more suitable.

Dean Fang hugged Chu Chu silently.

very scary……

Zhou Yuan’s technology has reached the point where no skill is required at all.

No wonder his title says the perfection of toe transplantation and reconstruction of the thumb!

During this period of time, he has transformed the finger reconstruction surgery that only Zhou Yuan can perform, through countless techniques and tricks, into a practical surgery that other people can also try! A.