Medical road

"Start!" Liu Yaowen said dullly.Because the hands are too contaminated, disinfect them first.This kind of surgery can't cause problems from the beginning, especially this disinfection, because skin grafting is necessary. Once infected, the transplanted skin may rot and die.So the disinfection here is too important.

The soapy water, Zhang Fan wears gloves and brushes it on Wang Lao San's hand non-stop. The bloody water is accompanied by black motor oil. The soap bubbles are all flowers, colorful under the shadowless lamp.

"Iodophor!" After washing with soapy water, I started disinfecting with Iodophor, and the nail of Wang Lao San's index finger and middle finger was also directly peeled off.After disinfection, the subcutaneous tissue is very clear. Some of the white tendons have been broken, and some have been cut in half. The thin skin is directly bone.

"Bao Yin, cut the remaining nails a bit shorter," Zhang Fan explained to Bao Yin.

"Good." Sometimes, the nurse's job is really difficult.If you are tired, you still can't let the world understand.

In the past half month, Zhang Fan's surgery volume, especially general surgery volume, has been rising.But when I encountered the operation, I didn't have any thoughts at the time of the operation.

After the operation, Zhang Fan felt a little awkward watching the progress of the system's operation.How should I put it, I don't want to have more operations. It's a bit of a duplicity. I want to have more operations, but I don't feel the heart. It's really awkward.

But when Zhang Fan encountered the operation, although Zhang Fan couldn't talk about being happy, he was still very excited, as if all the cells in his body were excited.This operation is the same as fitness. Now even if Zhang Fan doesn't have the system, he will be so refueling, because this thing can be addictive.

Skin graft surgery, especially hand skin grafting, is very demanding.First of all, we must choose wear-resistant skin, because there is too much hand movement, if the skin is thin, it will wear out in two strokes.And also to ensure the functionality of the fingers.

"Doctor Lu, prepare the skinning knife. Baoyin, come to our two shops."

"Okay." The two girls replied at the same time.Zhang Fan and Baoyin shop, and Lu Shuyan prepares a skinning knife.Let alone peeling this skinning knife, it can penetrate people in your hand.

This thing seems to have a natural suffocation.The simplest one is that the blade is clamped between two iron bars. One end of the iron bar is a rocker, which is shining coldly.It is very sharp, close to the skin, and shake it with your hand, the skin is directly thinned down, you can feel as thick as you want.

"Start." Zhang Fan and Lu Shuyan sat down face to face, luckily they were hands.If the feet are such a narrow place, it is estimated that Zhang Fan and Lu Shuyan will have to kneel for surgery.

"Doctor Zhang, come and I'll put a piece of gauze for you." The visiting nurse said, gently placing a piece of gauze on Zhang Fan's forehead.Surgical carts are still small and the temperature adjustment is relatively slow.

The skin of Wang Lao San's two fingers was damaged.The other fingers were still injured intermittently, and the middle finger of the index finger was directly scratched by the wheel.

"The middle finger can't be kept." Zhang Fan gently said to himself while gently pulling the muscles with tweezers to detect the damage.

"Isn't the bone quality complete?" Lu Shuyan asked in confusion.During this period of time, she had let Zhang Fan practice it, and the skill she had under her hands had also improved a lot. Now that the girl is guilty and not dead, she doesn't know, but she already respects Zhang Fan.

"The bone is intact, but you can take a look at this muscle. It is a combination of burns and crush injuries. The typical damage, the central tendon bundle and lateral bundles are completely damaged." Zhang Fan kept pointing with tweezers. Explain the damage to Lu Shuyan.

This finger, the most classic human finger is the muscles surrounding the finger.beautiful.If you go to see a fresh autopsy, the muscles in other places are nothing to behold. Pigs, horses, cattle and sheep are almost the same.

Only people have this finger. It's too classic.After opening it layer by layer, after cutting the interosseous muscles and worm muscles, it will be directly displayed in front of you like a fighter plane or a two-handed sword in the Middle Ages.

Various tendons surround the extensor tendon, which is too complicated to say. Simply put, there are several muscles involved in a flexor or extensor muscle.

"Can't it be repaired?" Lu Shuyan asked innocently. After all, she didn't do microsurgery, and she really didn't know much about it.

"This kind of injury is a doctor's nightmare. There is almost no complete organization system. There is no way. The stump is buried! The index finger is still a little hopeful, and the function of the hand is still complete in the future. Start." , Zhang Fan and Lu Shuyan lowered their heads to work at the same time.

Repairing tendons, repairing blood vessels, bones is not a big deal.Under Zhang Fan's soft guidance, Lu Shuyan was performing the operation in pain.

The noodles I had originally eaten were a bit hard, and then the sour wind and long time sitting in a fixed position, Lu Shuyan’s stomach seemed to be aching together. This would cause the girl to have a cold sweat. She gritted her teeth and cooperated with Zhang Fan without saying a word. .

"Bone tongs!" Zhang Fan said to Baoyin, raising his head.

"Dr. Zhang, do you really want to embed the stump?" Baoyin had never been on the table with hand injuries, so he asked curiously. After asking, he seemed to feel a little reckless, so he quickly lowered his head to pack the equipment.

Although Zhang Fan didn’t care, he explained: “Shortening the injured finger is not necessarily worse than repairing the skin flap. Especially in this case, combined with the age of the patient, embedding the stump is the best choice. It’s better to keep the finger’s beauty. The length and loss of function of the fingers may be a drag for the patient."

"Oh! I'm just curious." Baoyin explained awkwardly.On the operating table, unless it is an unlicensed doctor, the general nurse will not question the doctor.This is the industry's rules, not regulations.

After taking care of the hand injury, the whole hand looked pleasing to the eye. Zhang Fan's meat filling had already been removed, and it was time to mend it. There has been such a thing.

"Skin!" Zhang Fan said vigorously.The Long March is finally halfway through.Lu Shuyan gritted her teeth and almost swayed when she stood up.

"What's the matter?" Zhang Fan looked at Lu Shuyan and asked, his mask and hat were tightly wrapped, and he couldn't see the other person's expression clearly.

"It's okay." Lu Shuyan said in pain.Now even if it hurts again, there is no way, Zhang Fan can't do this operation alone.Even if other doctors and nurses are on the stage, they can’t help Zhang Fan, because they are not surgeons, so now Lu Shuyan can only fight hard!

Lifting off the surgical drape that left the opening, Wang Lao San’s white thighs were leaked, and the legs were pushed cleanly. Looking at the surgical drape, people who didn’t know thought that there was a beauty lying there, too white. .

Peeling, whether it is peeling with bare hands or peeling with a peeling machine, must be close to the skin, press tightly, and adjust the spacing of the blades. This spacing represents the thickness of the peeling.Then as the roller turned little by little, the skin was gently peeled off like tofu skin.

If the peeled skin does not have subcutaneous tissue, it will be exactly the same as the skin on the ping-pong racket.After the skin of the table tennis racket is pulled off, there are dots of yellow or red on it.

The skin is also the same. The inside of the skin thinned by the skinning knife is also lined with fat particles or hair follicles, almost exactly the same.Of course, doctors with poor skills have different skin thicknesses.

Zhang Fan got home with technology, and his skin was covered with shadowless lamps, and the squares were almost the same thickness.

"Pretty!" Zhang Fan couldn't help boasting himself.Cruel art.

"Don't be ashamed!" Zhang Fan said, and everyone was alive in the surgical cart. Baoyin smiled and joked quietly.

"Our hospital skinning Zhang Fan is the first one, haha!" Liu Yaowen said with a smile while adding anesthetics. The operation time is too long, and the patient can wake up with pain without adding a little.

"Haha! Warm salt water gauze." Zhang Fan ended the chat.Then, after gently wiping the peeled soft tissues with saline gauze, the operation time was too tight and it was too late to deal with it carefully. For larger bleeding, Zhang Fan was directly electrosurgically coagulated.Then the skin was pulled up with a big needle and thread, and stitched together.

There are many operations. The skin stitches of the patients are very rough and not detailed at all. It feels like they are fooling people. In fact, this is to prevent necrosis. The small needles and thin threads are beautiful and can easily cause ischemia to cause necrosis.Fortunately, this wound is on the thigh, so it doesn't matter.The old man does not wear super short!

The peeled skin was half the size of a piece of A4 paper. Zhang Fan held it in his hand and placed it on the affected hand. After lightly comparing it, he said to Baoyin, "A sharp knife."

Then he said to Lu Shuyan: "Fix." Lu Shuyan had never had skin grafts, and she didn't quite understand. She was shocked and asked embarrassedly: "How to fix."

"Use Alice forceps to flatten and fix the four corners!" Zhang Fan was a little impatient, but after thinking about it, he felt the same. He is a gynecologist, not an orthopedist, and not a general practitioner!

Then he added: "It must be stretched, otherwise the positioning will be biased."

Lu Shuyan's face turned red, although she yelled again in her heart: "My old lady's stomach is full, you are still fierce to me, I am in gynecology, I am in gynecology!" But she just shouted in her heart, who would let her It's the doctor, who made her the surgeon.

After fixing, Zhang Fan took the knife and started embroidering.Yes, it is embroidery.Because it is an avulsion injury, the skin on the surface of the finger is not left at all. If you want the transplanted skin to survive, you have to make a glove for it.

Choosing a good location, Zhang Fan began to use a knife to slowly draw a few small holes in the peeled skin. The holes should pass through the fingers, not too big or too small.

If the subcutaneous tissue is too large, it will leak out, and if it is too small, the blood can't be transported, so it is very elegant, and this skin graft is just this one, there can be no mistakes, and if you make a mistake, you can only replant it!Is skin replantation possible?impossible.So Zhang Fan was very careful.

After the hole was completed, Zhang Fan breathed a sigh of relief. Although this is a small detail, this small detail is very important, and it can be said to be related to the success or failure of the operation.

"The gloves are ready, let's try the size." Zhang Fan said to Lu Shuyan.

"The size should be ok, it's almost the same at a glance." Liu Yaowen couldn't help but interject.

Baoyin was very boring the whole time, and Lao Liu spoke, and she quickly asked, "If you can, can you tell the size at a glance?"

"Haha, I actually have more research on depth!" The old man said without embarrassment.

"Rogue." Baoyin didn't know if it was a shy smile, and so did she. She knew she was an old man, and she loved to tease.

Zhang Fan grasped both ends of the peeled skin.When unfolded, the skin is stretchable and contractible, and it can shrink into a paeonal skin without unfolding.

Lu Shuyan grasped Wang Lao San's two fingers, erected straight, gently, and put them down little by little.With a little friction, Zhang Fan slipped his skin down.

"OK! The size is right." Zhang Fan said lightly after looking at the gap.

"Look, I'm accurate!" Old Liu laughed.Baoyin ignored him again.

Putting on his fingers, Zhang Fan covered the skin on the back of his hand and fingers, and then cut the skin into long strips on the fingers, and then spirally wrapped the strips around Wang Laosan's two fingers.

"Suture." Zhang Fan gave an order, and several people moved. The anesthesiologist was preparing to wake up, the nurse threaded the needle, and Lu Shuyan used scissors to cut the thread and tied the knot.

A hand surgery takes almost longer than a femoral fracture surgery, because the division of the muscles of the hand is too detailed. If it is done a little sloppy, the patient's finger function will have problems after surgery.

Suture, compression bandage, the operation is over."You must pay attention to the infection after the operation. It is not possible here. I must be sent to the county hospital." Zhang Fan said while bandaging.

Finally Zhang Fan began to knot the gauze, and Lu Shuyan fell down swayingly, "Pump!" All of a sudden the girl fell on the operating table.

"I'll go!" Zhang Fan was shocked.Immediately put Wang Lao San's hand on his chest and said to Bao Yin, "Grab!"

After Baoyin grabbed Wang Lao San's hand immediately, Zhang Fan rushed over and pulled off Lu Shuyan's mask. At first glance, the girl clenched her teeth with a painful look on her face.

"What's the matter?" He said, putting his hands into Lu Shuyan's clothes.

Zhang Fan didn't go to get cheap, but to touch the girl's carotid artery.Lu Shuyan's painful look made Zhang Fan so frightened that she thought she had a heart attack.

"It's okay! I'm okay, but my stomach hurts. I feel a little uncomfortable and dizzy after standing for a long time." After a little relief, Lu Shuyan opened her eyes and said weakly.

"Are you sure? I'll do a physical examination for you." Zhang Fan said.

"Uh! No, I'm really fine." When Zhang Fan was about to check his body, Lu Shuyan's originally blue face turned blush.The physical examination, the abdominal examination is to lift the belly, she is shy.

"Oh, I'm scared to death, so quickly go down and lie down for a while. If you don't wake up, Zhang Fan will probably give you artificial respiration." Old Liu was not lightly scared, although he said it lightly, but his face was shocked. Didn't disappear yet.

"Come, hurry up, come over and give her a hand, I will carry her back." Zhang Fan ignored his nonsense and said to Old Liu.

Wang Lao San was pushed down, Lu Shuyan was backed down, and the five-hour operation was over!