Chapter 438: Willful surgery! Unparalleled skills!

In the operating room, everyone was a little uneasy.

Especially Wang Shengde, the director of hand surgery, Noah and others.

They have been in this industry for a long time, so they understand how desperate the current situation is.

They once hoped to challenge the limits of human surgery and break the forbidden zone of hand surgery, but after so many operations, watching countless patients who they thought they could save have to give up their hands, this feeling of powerlessness also made them more respectful of medicine.

What Xu Qiu is doing now is actually challenging the surgical forbidden zone that they once thought was untouchable.

"Huh."

Everyone was in a particularly heavy mood, and even their breathing became cautious.

However, facing all this, Xu Qiu's expression was still extremely calm, as if he was just putting a band-aid on the patient, with a relaxed and calm face.

"Scissors." He stretched out his hand.

The ophthalmic scissors were passed to Xu Qiu, who quickly cut away the subdermis along the edge of the stump. When he cut the skin on the back of the finger, he almost cut along the dermis and 0.1mm above the subcutaneous vein on the back of the finger...

Then, he used the right vascular nerve bundle on the left palm as the center point to first debride the blood vessels and nerves on that side.

Then he switched to microscissors, carefully removed the bruised and contaminated tissue around the blood vessels and nerves, and simply peeled off the tissue outside the adventitia of the artery.

After completing this step, he gradually expanded the debridement range to the surrounding and opposite sides.

When the debridement expanded to the vascular nerve bundle on the opposite side, Xu Qiu stopped, turned his wrist, and began to do the same debridement with the vascular nerve bundle on the opposite side as the center.

Finally, he simply cut off a layer of fat interstitial tissue with a thickness of about two millimeters.

"This, this is called simple?!"

Yang Yuen was shocked.

It was the same debridement, but she was like brushing the hair of a pig and bathing it, while Xu Qiu seemed to have done a delicate SPA.

How can the same operation have such a big difference!

Moreover, it is not just debridement.

Xu Qiu's eyes scanned every structure of the broken palm like a machine, and the next moment, a clear three-dimensional image appeared in his mind.

It is almost impossible to do this in a short time.

However,

Xu Qiu already has a normal anatomical palm section in his mind.

Therefore, what he needs to do is not to remember all the structures of Qiu Qinghu's palm, but to slightly shift and adjust the normal structure in his mind... For Xu Qiu, it is just a slight change in the anatomy that has been engraved in his mind.

Of course, outsiders don't know all this.

While they were still shocked by Xu Qiu's debridement technique, the latter had already cut the fascia layer under a six-fold microscope and marked the pale and dark red thin strips in turn.

This is the vein of the palm.

Pale is the color of the blood vessel itself, and dark red means that there is a small amount of blood in it.

This is a very bad sign, which means that the operation must be accelerated, otherwise once the stagnant blood coagulates in such a thin blood vessel wall, there is almost no chance of dredging again!

It can only be abandoned!

For Qiu Qinghu, who has few good blood vessels to use, this blow is enough to be fatal.

"Three veins that can be anastomosed are found on the back of the finger."

"Two small veins are also found in the fascia on the palm side of the finger..."

In the operating room, Noah and others exclaimed.

Other doctors are trying their best to find blood vessels in various gaps and anatomical structures, and often spend an hour on this.

However, in front of Xu Qiu, blood vessels are like the opposite sex, and they are eager to jump in front of Xu Qiu...

This is too outrageous!

Others are looking for blood vessels everywhere to gather enough blood vessels that can be anastomosed and survive.

And here, Xu Qiu has so many blood vessels to choose from that it is frightening!

"5-0 line marking."

After Xu Qiu finished speaking, the director of hand surgery and Wang Shengde's beloved disciple Yue Pan rushed to help and quickly marked the corresponding blood vessels.

"Done!"

As Xu Qiu picked out the retracted finger flexor tendon from the flesh and blood, everyone was stunned.

Next, the formal replantation will begin.

There are two conventional replantation methods in clinical practice, or two sequences.

One is antegrade replantation.

The steps are: debridement-bone fixation-extensor and flexor tendon suture repair-dorsal digital vein anastomosis-dorsal skin suture-proper digital artery anastomosis-digital nerve anastomosis-palmar skin suture.

The other is just the opposite, retrograde replantation.

This method first sutures the palmar skin, followed by the digital nerve anastomosis, the proper digital artery anastomosis, the flexor tendon suture, and finally the extensor tendon, dorsal digital side, etc.

There is no advantage or disadvantage between the two.

The only advantage of the retrograde method is that you don't need to turn your hands frequently during the operation, and you can do it smoothly all the way to the end.

For doctors, whichever one is more convenient to use will be used.

"0.8mm Kirschner wire."

Xu Qiu took the instrument handed to him, quickly and accurately drilled from the bone marrow cavity of the finger stump to the fingertip, and then drilled retrogradely into the proximal bone marrow cavity until it passed through a joint before stopping.

This step is actually similar to stringing candied haws.

Or exactly the same.

The same red color, the same crunchy and soft texture.

It’s just the finger joints that are being strung together.

Swish.

In the blink of an eye, Xu Qiu had already fixed each replanted finger, and then he reinforced it with a stitch on both sides of the flexor tendon.

“This is…”

With the appearance of the reinforcement needle, Noah, Abel and others' pupils shrank.

They immediately realized what Xu Qiu was doing.

Kirschner wire fixation and connecting the finger joints are indeed the best way to fix the broken finger on the original stump.

However, there is a huge flaw - it is easy to rotate.

Xu Qiu also took this into consideration, so he directly used amazing suturing techniques to perform fine suturing on a small piece of finger flexor tendon, which will be directly fixed completely.

"Too willful!" Noah was amazed.

As the saying goes, less is more and less is fine in surgery.

Any additional operation will increase the risk.

What's more, it is a step of suturing and reinforcing the tendon, which is extremely considered as the basis of suturing?

Others dare not do it at all.

But Xu Qiu's suturing technique is so skilled that it makes people smack their lips, which also makes him dare to use it boldly to solve many problems that other clinicians dare not think of.

For example, rotation.

Other doctors may let their assistants act as human fixators throughout the process, but Xu Qiu dares to use needles on the tendons.

Only he dared to take such a risk.

"It's time to anastomose the blood vessels." Noah and others regained their spirits.

Blood vessels and nerves are the key to whether the finger can survive.

For these two structures, the only way to deal with them is to repair them.

However, this is the most difficult operation in the entire finger replantation.

Blood vessels and nerves are extremely thin, and the needles used for suturing are as thin as cow hair.

The most fatal thing is not this.