Start From Emergency Doctor

Chapter 298

“The Concise Psychiatric Rating Scale is a scale for assessing the degree of psychotic symptoms in the eyes. May I ask you whether you will be tested immediately on the 18 conditions of your body?”

Zhou Yuan’s mouth twitched: “Go away.”

System: “Listen to cross talk?”

Zhou Yuan’s face was black, “Be yourself.”

With that said, he directly blocked the system and looked at Yang Yongxin.

The toe transplantation is only done once to reconstruct the thumb. How dare you do it while listening to the cross talk?

Moreover, this is not just an operation. The people around are watching, Zhou Yuan is definitely going to teach.

“Can you start?” Wu Guohui couldn’t wait.

Haiyang and the others also stared at Yang Yongxin on the operating table, wishing to chop his feet immediately.

Zhou Yuan nodded and took the scalpel.

“The first is the choice of the recipient artery…”

This step is not difficult for Zhou Yuan. It just exposes the arteries of the upper limbs that need to be anastomosed.

“The recipient artery is anastomosed from the terminal branch of the ulnar artery and the superficial metacarpal branch of the radial artery to form a superficial palmar arch. From the arch flange, four common palmar arteries are sent out along the palmar space. Each common palmar artery is separated from the finger web. The centimeter is divided into two palmar proper arteries. The proper arteries are dissected, marked 010, and fixed…”

Zhou Yuan’s tone is calm and calm, and his operation is smooth and smooth.

Wu Guohui stared at Yang Yongxin’s hand. Under Zhou Yuan’s scalpel, Yang Yongxin’s broken index finger and middle finger were quickly removed.

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

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

“Starting to dock…connected?!”

“The blood vessels are beginning to be revealed… Is it done?!”

“Starting to remove the stump… is it done?!”

Director Wang’s face was black: “Can you not make a fuss?”

Wu Guohui stepped back from the microscope in shock, “Director Wang, look for yourself, Zhou Yuan has started to dissect the tendons.”

Director Wang smiled slightly.

But I saw it.

He walked up and looked into the microscope: “…Is this the dissection is finished?!”

In about an hour, Zhou Yuan completed the treatment of the receiving area, that is, his hands.

Zhou Yuan set his sights on Yang Yongxin’s toes again, and said, “Next is the choice of donor artery.”

“Marker pen.”

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

Avoid important blood vessels and difficult-to-heal tissues in order to choose the best opening position.(Read more @ wuxiax.com)

This is the basic skill and the key to determining the effect of surgery.

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

Grasping the balance between the two is a skill that a doctor must master.

“All right.”

A few minutes later, Zhou Yuan drew lines along Yang Yongxin’s blood vessels in his feet.

These threads can accompany just around the blood vessel, which can minimize bleeding and quicken healing, but it puts high demands on the technique of the main knife.

After all, if you accidentally cut off the blood vessels next to it, there are arteries in this place, and blood may be soaked at that time.

“The choice of donor artery is more complicated.”

Zhou Yuan dropped the knife, cut through the skin along the line, and explained.

“The first dorsal metatarsal artery extends to the first toe web, and two dorsal toe arteries are separated near the metatarsophalangeal joint. The two dorsal toe arteries are distributed on the dorsal toe opposite to the second toe. Reveal .”

“At the web of the first toe, the two proper plantar arteries on the opposite side of the second toe of the middle toe. This is a mixed artery. The branches from the first dorsal metatarsal artery make up 45% of the arteries. The branch from the common artery makes up 36% of it, and the mixed branch of the two arteries makes up 19%. Revealed.”

“There is an anastomosis in the superficial fascia between the dorsal toe arteries on both sides, the proper plantar arteries of the toes, and between the dorsum of the toes and the proper plantar arteries of the toes. Be careful when separating.”

Zhou Yuan said, exposing the artery in the mouth with a scalpel while demonstrating how to complete the best separation.

“I chose a V-shaped incision.” Zhou Yuan said.

Wu Guohui, Haiyang and others nodded.

Choosing V-shaped incisions is actually taking care of them.

If it is a more difficult incision method, I am afraid that this group of people cannot master it…

Zhou Yuan knew what they were thinking and explained: “V-shaped incisions are also good. Conventional free second toe reconstruction thumb surgery, whether it is toe extraction or hand area preparation, is more traumatic. Especially the feet For toe cutting, almost one incision can penetrate the entire foot.”

“This requires all the skin of the foot to be removed again, which will cause great damage and time-consuming. The V-shaped incision we chose has minimized trauma whether it is for toe removal or treatment of the affected area.”

After a little more than an hour, the free toe was also completed.

The next step is the transplantation and reconstruction process.

This step is the most critical for toe transplantation to reconstruct the thumb.

The cost and time-consuming of the operation are closely related to the number of blood vessels and nerves to be anastomosed.

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

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: “This is…completed?”

Morimoto Hikaru: Sri Kuniichi…”

Morimoto had nothing to say now.

He also began to understand why Zhou Yuan dared to carry out the finger reconstruction project…because Zhou Yuan’s ability to replant severed limbs is so strong!

It’s okay to say a few large arteries and large veins, even if you can figure it out by fumbling, but…what about the vascular network?

Even Zhou Yuan’s anastomosis of the vascular network is smooth and flowing…

“Seven hours, it’s okay.” Zhou Yuan relaxed a little.

“Director Wu and Director Wang, can you still hold on?”

Wu Guohui smiled: “I’m not old enough! And it’s just a help, and I’m still standing!”

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 to reconstruct the thumb is not a minor operation. 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 per day is already the limit!”

Zhou Yuan glanced at the time.

The operation started at nine o’clock in the morning, and it is now six o’clock in the afternoon.

“You don’t really want to do it together, do you?” Wu Guohui swallowed.

To be honest, both he and Director Wang were able to hold on. Just being an assistant, physical exertion is not so scary.

Zhou Yuan shook his head: “Of course I won’t do it in succession.”

Hearing these words, Wu Guohui and others just prepared to breathe a sigh of relief, Zhou Yuan said again: “We haven’t eaten the meal. Let’s continue after the meal.”

“???”.