Chapter 263 Xu Qiu, you are such a pervert!
"Hmm?"
Everyone looked over.
Academician Chen smiled and said, "Xu Qiu is leaving now, but the operation is not over yet. Who will do the suturing afterwards?"
This step is not simple at all.
First, the TALENT catheter must be removed, and then the femoral artery incision must be sutured horizontally and layer by layer with 5-0 Prolene sutures. The suturing is very demanding.
"I'll do it!"
Suddenly, Wang Fan said excitedly.
Li Mingwei, Yang Chenxi and others were a little hesitant.
In addition to Xu Qiu, the most famous person in this famous knife competition is Wang Fan.
The latter also has a nickname, the newspaper seller.
None of the things he does have anything to do with doctors.
Moreover, it can be seen in this operation that Wang Fan's ability is even behind the most insignificant attending doctor, who is an ugly mascot at best.
Still not handsome.
Suturing is not difficult compared to the main interventional surgery, but it is the end of the entire operation and is equally important.
Can it really be given to him?
Even Wang Shengde was a little skeptical.
However, Qin Qiyin, Yan Na and other teammates all nodded.
These days, Wang Fan is actually very hardworking. His foundation is worse than others, so he started from suturing.
In the past two months, he specifically asked Xu Qiu for advice, and also learned from Xu Qiu to practice with the blood vessels of chicken feet and chicken wings. Now Wang Fan wants to catch the chickens playing basketball and sew them up.
He even gained three pounds because of eating too many chicken wings.
It can be said that after Xu Qiu's guidance and Wang Fan's own special training, although his intervention is not as good as Qin Qiyin, his suturing will never be inferior.
"I have been practicing for two and a half months."
Wang Fan raised his head, and the moment he picked up the needle, he also learned some of Xu Qiu's temperament.
But the next moment he broke down.
"It's so beautiful!"
Wang Fan looked at the incision made by Xu Qiu and showed a slightly perverted smile.
Soon, the needle fell.
Insert.
Pierce out.
Tighten.
Tie a knot.
Several boring movements are the most essential and basic skills of surgeons.
Wang Shengde looked surprised.
Is this really Wang Fan who is bullied by the pretty nurses in the emergency department every day?
He has grown up!
No.
Everyone, Li Xue, Yunmei, Qin Qiyin, Yan Na, and even Liu Susu, Yang Meng and Chen Qiao, are completely different from a few months ago.
They are more like doctors than before, and they seem to understand how to become a better doctor from Xu Qiu.
These people are also transforming!
Wang Shengde sighed. At this moment, he had a feeling that perhaps these people who had followed Xu Qiu to compete in the famous knife competition would become true geniuses and leaders in their respective departments after returning.
Except for a few in the emergency department.
…
Twenty minutes later.
The operation of replanting severed fingers + artificial blood vessel transplantation to repair limb vascular defects officially began.
Yang Chenxi came closer.
When using artificial blood vessels to repair lower limb arteries, the most common clinical cases are not car accidents or other accidents, but femoral artery pseudoaneurysms caused by drug injection.
Treating such patients is a headache for anesthesiologists.
Most of these patients have varying degrees of damage to their hearts, livers, and kidneys, so they are prone to hypotension during anesthesia, which is more risky.
The surgeons are actually not very willing to perform surgery on them.
A large proportion of these people will be injected again, causing problems with the newly transplanted artificial blood vessels, and often end up with amputation.
Although the patients have spent money, they have occupied medical resources, and doctors are more willing to give the opportunity to operate to those who really want to save their legs.
"Let's get started."
Yang Chenxi was distracted for a moment, and his attention was brought back by Xu Qiu's words.
The replantation surgery officially began!
The first step is debridement.
However, when the patient was admitted to the hospital, the doctors at Union Medical College had already thoroughly debride the stumps and cryopreserved stumps left on the patient.
At this time, Xu Qiu removed the gauze and just cleaned up the new necrotic tissue that was damaged and ischemic.
The second step is to flush the vascular bed.
This is also a crucial step.
There are three purposes for flushing.
To understand the integrity of the vascular bed of the severed limb and confirm the degree of replantation;
To flush the metabolic products and vascular clots accumulated in the tissue and reduce the body's absorption of toxic substances;
And the last point, to dilate the spasmodic and closed small blood vessels and capillary networks.
Gurgle---
Xu Qiu inserted the 18-gauge needle into the vascular cavity, and then pushed the 20ml syringe to slowly push the full heparin saline into the vascular cavity.
Under moderate resistance, the flushing fluid flowed out from the aortic communication branch, the bone marrow cavity and the venous fracture.
At the same time, there were also some blood clots, as well as gray and black necrotic tissue.
"The femoral artery and popliteal artery must be replaced."
These blood vessels have great resistance to flushing, and there is almost no venous return.
It is obviously severed, and artificial blood vessels must be used to replace it.
And this is also the point that Yang Chenxi cares most about in this operation.
"Yeah." Yang Chenxi nodded and waited.
The vascular anastomosis is still to come, so don't rush.
First, the bone is fixed.
The bone is the basis of the replantation surgery, and it is also the support and support for tissue repair.
For Xu Qiu, who has experience in bone reconstruction, this step is not too smooth.
The bone ends are bitten into a stepped shape...
Two screws are inserted to fix...
One end of the bone is inserted into the other epiphysis...
The operation process was so smooth that it was pleasing to the eye.
This time it was the turn of the orthopedic director to be shocked.
Is this the doctor who just performed cardiac surgery intervention?
How come bone surgery is not inferior to that of the orthopedic director!
Lin Xie had already gone through this stage. He smiled and said, "You'll get used to it. His bone reconstruction is better than bone fixation."
Orthopedic director: ...
What kind of pervert is this?
...
Soon, the bone construction was completed, and it was time for the highlight - vascular anastomosis.
"Replenish blood volume." Xu Qiu's calm voice resounded in the operating room.
The anesthesiologist accelerated the rate of fluid infusion and maintained the systolic blood pressure above 100mmHg.
This is a feature of limb replantation surgery.
A high blood volume must be guaranteed!
Because once there is not enough blood and the blood vessel cavity is not filled enough, the blood vessel will collapse, which can easily cause spasm.
When the blood flow rate is slow, thrombosis is also easy to form at the anastomosis.
In addition, after the replantation operation is completed, the reattached limb needs a lot of blood to fill. If the blood volume cannot keep up, the patient's effective circulating blood volume will drop rapidly, and shock is very likely to occur at this time.
This is actually the reason why the aneurysm operation must be performed first.
If the broken limb is replanted first, the blood volume is replenished, and then the aneurysm is performed at this time, the 1,000 milliliters of accumulated blood will quickly return to the patient's blood vessels.
At this time, the excess blood will violently impact the heart, kidneys and other organs, causing serious organ edema, and even heart failure and kidney failure!
"Doctor Xu, it's OK." At this time, the anesthesiologist's voice sounded, confirming that the patient's systolic blood pressure was stable at around 105.
Xu Qiu nodded, and the scalpel was about to fall, and there was a sudden sound of footsteps outside the operating room, which was obviously coming here.
His movements stagnated.
Other people in the operating room also looked at the door at the same time.
