Medical road

Zhang Fan was the chief surgeon and Chen Qifa was an assistant. The palm replantation operation was performed on a table. The surgeons sat face to face to perform the operation. The instrument nurse's instrument cart was parked opposite the patient, so the third doctor did not Location!What to do, Tong Lili can only stand on Zhang Fan's left hand side. There is no way to put down the stool. If you don't want to go to the operation, you can not go to the operation. If you want to go to the operation, you have to stand.

Because of the long operation time, the anesthesiologist chose general anesthesia instead of brachial plexus block after consulting Zhang Fan.Surgery, especially orthopedic surgery, attaches great importance to debridement. Complete removal of contaminated and lost vital tissue is the basic principle of surgery, and this debridement is not performed at will.

X-rays must be carefully studied before surgery, and then combined with the specific conditions of the palms to determine the scope of debridement and the length of bone shortening. Because it is a dissected operation, the dissected palm is like a flesh-colored rubber doll without a trace of blood. !Put it on the ground, if you don't look carefully, you might be able to see it as a rubber doll's hand!

Due to the development of surgery, instrument nurses are becoming more and more important. A mature instrument nurse cannot be skilled in cooperating with surgery without one or two years of training. Doctors perform operations in different departments, but instrument nurses do not. So instrument nurses Must be proficient in knowing the nouns of all instruments, and also proficient in surgical procedures.

Because the doctor performs an operation, the equipment nurse has to prepare the equipment to be used in advance. If you are not familiar with the operation steps, you will be unlucky one day when you encounter a doctor with a temper, and can directly throw away the surgical equipment~!

A slightly older instrument nurse and a desk can tell at a glance how the doctor is. Therefore, young surgeons are very deliberate to please some old nurses in the operating room, because if they are not pleased, they can be heard. What words come.

The debridement of debridement surgery must be performed by two doctors at the same time, so as to save time and gain more time. Debridement must be performed at an anatomical level, while debridement is performed while looking for related nerves and blood vessels in related levels. Prepare for a one-step operation.

For this simple debridement, the surgeon in charge must think about the steps, which one to do first and which one to do, just like a battle. The formation of troops before the war must be clear in mind.

The most important of the palm muscles is the thenar. This muscle is unique to humans. The gorillas are genetically the closest to humans, but these hairy animals do not have the thenar. This is how much time the ancestors passed. It's from labor.Where is the thenar?It's the pimple muscle attached to the big finger.

After debridement of the muscles, the bones are the next step. In the metacarpal bones, the most important thing is the metacarpophalangeal joints. This joint must be kept as complete as possible.

Zhang Fan lowered her head to perform the operation with Lao Chen. Tong Lili's job was to ensure a clear vision of the operation. In layman's terms, it was to wipe the blood with the hook.This is how every surgeon comes here. First look at the operation. It is the so-called third and fourth assistant. The hook wipes the blood and sucks the blood with a suction device. For an operation, you will watch it dozens of times and then wait for the second assistant and the first assistant. Slowly go up.

During this period of time, some doctors gradually moved apart. Surgery is a work of talent and hard work.Some doctors deliberately train surgical skills after surgery. For example, to use some endoscopic techniques, he goes home and carries two similar poles to train non-stop.A big distance can be opened in one year. This is the difference between hard work and not hard work.

If you look carefully, many surgeons often hold these things in their hands and keep playing with them. This is not boring to play with, maybe they are training certain surgical skills.

After debridement, the broken bones must be repaired and fixed. This is a matter of principle. After the bones are fixed, other organs can be repaired. If the fracture is not fixed well, gently move the newly repaired blood vessels. broken!

After the fracture is processed, the muscle is repaired. If it is a fractured injury, the surgeon most hopes for a sharp cut injury. Because it is easy to repair, if it is a rolling injury, it is estimated to be very, very troublesome. Maybe there is no chance to repair it. Amputated.

After the muscle repair is finished, it is the blood vessels. Zhang Fan and Chen Qifa started to operate under the microscope.The thick veins should be anastomosed as much as possible. This is the channel to ensure the return of blood. Arterial repair should be decided according to the situation.The radioulnar artery is easier to do end-to-end anastomosis.

Generally, the incidence of palmar interruption is the highest, and the survival rate after replantation is also the lowest. This is because it is related to the difficulty of rebuilding blood supply.

When the common finger artery is broken at the distal end of the two finger proper arteries, this is troublesome. The main surgical knife must be designed well, because one common artery can only be anastomosed with one proper finger artery. It may be difficult to design. One finger lacks a direct blood supply.Then the end circulation is not good, which is especially easy to cause some sequelae.

In order to restore the function of the hand to the best condition, the nerves must be repaired in principle. The disconnection of the sensory nerves, whether in the carpal tunnel or the palm, should be repaired in one stage. This is too important.

The operation was carried out slowly, and time was lost. Because it was operating under a microscope, Tong Lili became boring as she looked at it. She didn't know where Zhang Fan and the others were, and she couldn't see clearly what they were doing.

And it has been more than two hours. I was very tired after a sleepless night shift. Now I stand for more than two hours, my calves are sore and my feet are numb.She was almost unable to hold it up, and she had clenched her teeth until now.

Zhang Fan's operation was fairly fast, and just like that, it took three hours to complete the suture of the nerve.The subsequent steps of the operation are simple. Zhang Fan and Lao Chen began to communicate, "Today you will have to do more snacks and pay more attention to the blood supply of your hands."

"Well, good master." Old Chen nodded.

"Regularly give antibiotics."

"OK, all right."

"Doctor Tong, which is the biggest complication of this kind of replantation?" Zhang Fan wanted to see if Tong Lili was a caring person, so he asked abruptly.

"Huh! Infection, necrosis?" Tong Lili said uncertainly.After standing for more than three hours and the boring operation of the later stage, she was already a bit mentally wandering, because she really couldn't stand without being distracted, but Zhang Fan asked fiercely, she couldn't tell.

"It is a vascular crisis, so patients with this type of surgery must not smoke or be in a smoking environment. Once a vascular crisis occurs, they must first use antispasmodic drugs. If it fails, a second operation will be required!" Zhang Fan explained .

The replantation of a broken palm is done and the bandage is complete.Zhang Fan stretched his waist and looked at Tong Lili who was still standing on the edge of the operating table and said, "Go! It's over."

"My legs are numb! I don't feel able to walk anymore!" Tong Lili's voice is full of crying, not because of leg numbness, but because she feels she can't adapt to this kind of work, not only is it boring, but the operation time is too long. Long.

She was sad, sad, and self-blaming. To be honest, if it weren’t for microsurgery, it would be difficult for a weak woman to perform surgery of this intensity. Wang Yanan is a special case, because hobbies are her biggest motivation. Tong Lili is different, she is to choose a good department.Departments that can not be marginalized.

Life is so cruel, unable to adapt, can't take it down, can only let Xian have to leave, there is no love to talk about, and the hospital is not a place to talk about love!

The nurse helped Tong Lili out of the operating room with difficulty. When she stepped out of the operating room, Tong Lili held on to tears for a long time, and finally fell on the blue mask.

I would rather have hope than despair!Tong Lili could not find the meaning of being in the operating room!She is really discouraged!My heart hurts like a knife!