Chapter 216: 216
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Zhang Fan is the chief surgeon and Chen Qifa is an assistant. The operation of palm replantation is done on the same table. The two operators sit face to face for the operation. The instrument nurse's instrument car is parked opposite the patient, so the third doctor has no place! How to do, only let Tong Lili stand on Zhang Fan's left hand. There is no way to put down the stool. If you don't want to go, you can't go to surgery. If you want to go to surgery, you have to stand.
Because the operation took a long time, the anesthesiologist asked Zhang Fan and chose general anesthesia instead of brachial plexus block. Surgery, especially orthopedic surgery, attaches great importance to debridement. The basic principle of surgery is to completely remove contaminated and lifeless tissues, and this debridement is not operated at will.
The X-ray film must be carefully studied before operation, and then combined with the specific situation of the palm to determine the scope of debridement and the length of bone shortening, because it is a broken operation. The broken palm is like a flesh colored rubber doll, without any blood color! On the ground, if you don't look carefully, you may be able to see the hand of a rubber doll!
Because of the development of surgery, instrument nurses are becoming more and more important. A mature instrument nurse cannot skillfully cooperate with surgery without one or two years of training. Doctors perform surgery in different departments, but instrument nurses will not be divided into different departments. Therefore, instrument nurses must skillfully know the terms of all instruments and be proficient in surgical procedures.
Because doctors do surgery, which step to do, instrument nurses have to prepare the instruments to be used in advance. If they are not familiar with the surgical steps, they will be unlucky to meet a doctor with a bad temper one day. They can directly throw away the surgical instruments ~!
The older instrument nurses can tell at a glance what the doctor's level is. Therefore, young surgeons deliberately curry favor with some old nurses in the operating room because they can't tell what to say if they don't curry favor with them.
The debridement of amputation surgery should be carried out by two doctors at the same time, so as to save time and win more time. Debridement must be carried out according to the anatomical level. While debridement, find the relevant nerves and blood vessels at the relevant level, so as to prepare for the next operation.
For this simple debridement, the surgeon in charge must think about the steps, which to do first and which to do later, just like a war. The arrangement of troops before the war must be clear in his mind.
The most important muscle of the palm is the thenar, which is unique to humans. Gorillas are genetically closest to humans, but these hairy animals don't have thenar, which is derived from the labor of human ancestors. Where is the thenar? It's the pimple muscle connected to the big finger.
After muscle debridement, the next is the bone. In the palm bone, the most important thing is the metacarpophalangeal joint. This joint must be kept as complete as possible.
Zhang Fan bowed his head and performed the operation with Lao Chen. Tong Lili's job is to ensure the clear vision of the operation. Generally speaking, it is to draw the hook and wipe the blood. Every surgeon comes here like this. First, he looks at the operation, which is the so-called third and fourth assistant. He wipes blood with a hook and sucks blood with a suction device. For one operation, he looks at it dozens of times, and then slowly boils up from the second assistant and the first assistant.
This period of time has slowly opened the distance between some doctors. Surgery is a combination of talent and hard work. Some doctors deliberately train surgical skills after surgery. For example, they need to use some endoscopic techniques. When he comes home, he keeps training with two similar poles. A year can open a great distance, which is the difference between hard work and not hard work.
If you pay attention, many surgeons often hold these things in their hands and keep playing. This is not boring to play, maybe they are training some surgical skills.
After debridement, the broken bone should be repaired and fixed first. This is a matter of principle. After fixing the bone, there is the possibility of repairing other organs. The fracture is not fixed well. Move gently, and the newly repaired blood vessel pops and breaks again!
After the fracture treatment, the muscle is repaired. If it is a broken injury, the surgeon's most hope is the sharp tool cutting injury, because it is easy to repair. If it is a rolling injury, it is estimated to be very troublesome. Maybe there is no chance to repair and amputate the limb directly.
After the muscle repair, the blood vessel is completed. Zhang Fan and Chen Qifa began to operate under the microscope. The thick veins should be anastomosed as much as possible, which is the channel to ensure the blood return, and the arterial repair should be determined according to the situation. Radial ulnar artery is easy to do end-to-end anastomosis.
Generally, the incidence of broken end in the palm is the highest and the survival rate after replantation is the lowest, which is related to the difficulty of revascularization.
When the common finger artery is broken at the proper artery of two fingers at its distal end, it is troublesome. The main knife must be designed well, because a common artery can only be anastomosed with the proper artery of one finger. If the design is not good, one finger may lack direct blood supply. Then it leads to poor terminal circulation, which is particularly easy to cause some sequelae.
In order to restore the function of the hand to the best state, the nerve must be repaired in one stage in principle. The disconnection of the sensory nerve, whether in the carpal tunnel or the palm, should be repaired in one stage. This is too important.
The operation went on slowly and lost a little time. Because it was operated under a microscope, Tong Lili became more and more boring. Zhang Fan didn't know what they were doing. She couldn't see clearly.
And it has been more than two hours. Originally, I was very tired after a sleepless night shift. Now I have stood for more than two hours. My legs are sore and my feet are numb. She can't stand it anymore. She has been gritting her teeth and insisting until now.
Zhang Fan's operation was fast. In this way, it took three hours to suture the nerves. The later operation steps were simple. Zhang Fan and Lao Chen began to communicate, "today, you'll have more snacks and pay more attention to the blood supply of your hand."
"Well, good master." Lao Chen nodded.
"Give some antibiotics routinely."
"Well, OK."
"Dr. Tong, which is the biggest complication of this replantation?" Zhang Fan wants to see if Tong Lili has a heart, so he asks fiercely.
"Well! Infection, necrosis? " Tong Lili said with a little uncertainty. After standing for more than three hours and the later operation was boring, she had a little brain wandering. Because she didn't distract a little, she really couldn't stand. As a result, Zhang fanmeng asked, she couldn't say.
"It is a vascular crisis, so the patients of this operation must not have smoking and in a smoking environment. Once a vascular crisis occurs, antispasmodic drugs must be used first. If it doesn't work, there will be a second operation! " Zhang Fan explained.
A severed palm replantation is finished. Wrap it up. Zhang Fan stretched out his waist, looked at Tong Lili who was still standing by the operating table and said, "let's go! It's over. "
"My legs are numb! I feel like I can't walk! " Tong Lili's voice is full of tears, not for leg numbness, but because she feels she can't adapt to this kind of work. It's not only boring, but also the operation time is too long.
She was sad, sad and blamed herself. To tell the truth, if she didn't really like microsurgery, it would be really difficult for a weak woman to do it. Wang Yanan is a special case, because her hobby is her biggest motivation, while Tong Lili is different. She is to choose a good department. Departments that can not be marginalized.
Life is so cruel, can not adapt, can not take down, can only let the virtuous, can only 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. When she stepped out of the operating room, Tong Lili insisted on tears for a long time and finally rolled down on the blue mask.
I'd rather have hope than despair! Tong Lili can't find the meaning of being in the operating room! She's really frustrated! The pain in my heart is like the stirring of a knife!
Please report us if you find any errors so we can fix it asap!
Zhang Fan is the chief surgeon and Chen Qifa is an assistant. The operation of palm replantation is done on the same table. The two operators sit face to face for the operation. The instrument nurse's instrument car is parked opposite the patient, so the third doctor has no place! How to do, only let Tong Lili stand on Zhang Fan's left hand. There is no way to put down the stool. If you don't want to go, you can't go to surgery. If you want to go to surgery, you have to stand.
Because the operation took a long time, the anesthesiologist asked Zhang Fan and chose general anesthesia instead of brachial plexus block. Surgery, especially orthopedic surgery, attaches great importance to debridement. The basic principle of surgery is to completely remove contaminated and lifeless tissues, and this debridement is not operated at will.
The X-ray film must be carefully studied before operation, and then combined with the specific situation of the palm to determine the scope of debridement and the length of bone shortening, because it is a broken operation. The broken palm is like a flesh colored rubber doll, without any blood color! On the ground, if you don't look carefully, you may be able to see the hand of a rubber doll!
Because of the development of surgery, instrument nurses are becoming more and more important. A mature instrument nurse cannot skillfully cooperate with surgery without one or two years of training. Doctors perform surgery in different departments, but instrument nurses will not be divided into different departments. Therefore, instrument nurses must skillfully know the terms of all instruments and be proficient in surgical procedures.
Because doctors do surgery, which step to do, instrument nurses have to prepare the instruments to be used in advance. If they are not familiar with the surgical steps, they will be unlucky to meet a doctor with a bad temper one day. They can directly throw away the surgical instruments ~!
The older instrument nurses can tell at a glance what the doctor's level is. Therefore, young surgeons deliberately curry favor with some old nurses in the operating room because they can't tell what to say if they don't curry favor with them.
The debridement of amputation surgery should be carried out by two doctors at the same time, so as to save time and win more time. Debridement must be carried out according to the anatomical level. While debridement, find the relevant nerves and blood vessels at the relevant level, so as to prepare for the next operation.
For this simple debridement, the surgeon in charge must think about the steps, which to do first and which to do later, just like a war. The arrangement of troops before the war must be clear in his mind.
The most important muscle of the palm is the thenar, which is unique to humans. Gorillas are genetically closest to humans, but these hairy animals don't have thenar, which is derived from the labor of human ancestors. Where is the thenar? It's the pimple muscle connected to the big finger.
After muscle debridement, the next is the bone. In the palm bone, the most important thing is the metacarpophalangeal joint. This joint must be kept as complete as possible.
Zhang Fan bowed his head and performed the operation with Lao Chen. Tong Lili's job is to ensure the clear vision of the operation. Generally speaking, it is to draw the hook and wipe the blood. Every surgeon comes here like this. First, he looks at the operation, which is the so-called third and fourth assistant. He wipes blood with a hook and sucks blood with a suction device. For one operation, he looks at it dozens of times, and then slowly boils up from the second assistant and the first assistant.
This period of time has slowly opened the distance between some doctors. Surgery is a combination of talent and hard work. Some doctors deliberately train surgical skills after surgery. For example, they need to use some endoscopic techniques. When he comes home, he keeps training with two similar poles. A year can open a great distance, which is the difference between hard work and not hard work.
If you pay attention, many surgeons often hold these things in their hands and keep playing. This is not boring to play, maybe they are training some surgical skills.
After debridement, the broken bone should be repaired and fixed first. This is a matter of principle. After fixing the bone, there is the possibility of repairing other organs. The fracture is not fixed well. Move gently, and the newly repaired blood vessel pops and breaks again!
After the fracture treatment, the muscle is repaired. If it is a broken injury, the surgeon's most hope is the sharp tool cutting injury, because it is easy to repair. If it is a rolling injury, it is estimated to be very troublesome. Maybe there is no chance to repair and amputate the limb directly.
After the muscle repair, the blood vessel is completed. Zhang Fan and Chen Qifa began to operate under the microscope. The thick veins should be anastomosed as much as possible, which is the channel to ensure the blood return, and the arterial repair should be determined according to the situation. Radial ulnar artery is easy to do end-to-end anastomosis.
Generally, the incidence of broken end in the palm is the highest and the survival rate after replantation is the lowest, which is related to the difficulty of revascularization.
When the common finger artery is broken at the proper artery of two fingers at its distal end, it is troublesome. The main knife must be designed well, because a common artery can only be anastomosed with the proper artery of one finger. If the design is not good, one finger may lack direct blood supply. Then it leads to poor terminal circulation, which is particularly easy to cause some sequelae.
In order to restore the function of the hand to the best state, the nerve must be repaired in one stage in principle. The disconnection of the sensory nerve, whether in the carpal tunnel or the palm, should be repaired in one stage. This is too important.
The operation went on slowly and lost a little time. Because it was operated under a microscope, Tong Lili became more and more boring. Zhang Fan didn't know what they were doing. She couldn't see clearly.
And it has been more than two hours. Originally, I was very tired after a sleepless night shift. Now I have stood for more than two hours. My legs are sore and my feet are numb. She can't stand it anymore. She has been gritting her teeth and insisting until now.
Zhang Fan's operation was fast. In this way, it took three hours to suture the nerves. The later operation steps were simple. Zhang Fan and Lao Chen began to communicate, "today, you'll have more snacks and pay more attention to the blood supply of your hand."
"Well, good master." Lao Chen nodded.
"Give some antibiotics routinely."
"Well, OK."
"Dr. Tong, which is the biggest complication of this replantation?" Zhang Fan wants to see if Tong Lili has a heart, so he asks fiercely.
"Well! Infection, necrosis? " Tong Lili said with a little uncertainty. After standing for more than three hours and the later operation was boring, she had a little brain wandering. Because she didn't distract a little, she really couldn't stand. As a result, Zhang fanmeng asked, she couldn't say.
"It is a vascular crisis, so the patients of this operation must not have smoking and in a smoking environment. Once a vascular crisis occurs, antispasmodic drugs must be used first. If it doesn't work, there will be a second operation! " Zhang Fan explained.
A severed palm replantation is finished. Wrap it up. Zhang Fan stretched out his waist, looked at Tong Lili who was still standing by the operating table and said, "let's go! It's over. "
"My legs are numb! I feel like I can't walk! " Tong Lili's voice is full of tears, not for leg numbness, but because she feels she can't adapt to this kind of work. It's not only boring, but also the operation time is too long.
She was sad, sad and blamed herself. To tell the truth, if she didn't really like microsurgery, it would be really difficult for a weak woman to do it. Wang Yanan is a special case, because her hobby is her biggest motivation, while Tong Lili is different. She is to choose a good department. Departments that can not be marginalized.
Life is so cruel, can not adapt, can not take down, can only let the virtuous, can only 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. When she stepped out of the operating room, Tong Lili insisted on tears for a long time and finally rolled down on the blue mask.
I'd rather have hope than despair! Tong Lili can't find the meaning of being in the operating room! She's really frustrated! The pain in my heart is like the stirring of a knife!
Zhang Fan is the chief surgeon and Chen Qifa is an assistant. The operation of palm replantation is done on the same table. The two operators sit face to face for the operation. The instrument nurse's instrument car is parked opposite the patient, so the third doctor has no place! How to do, only let Tong Lili stand on Zhang Fan's left hand. There is no way to put down the stool. If you don't want to go, you can't go to surgery. If you want to go to surgery, you have to stand.Because the operation took a long time, the anesthesiologist asked Zhang Fan and chose general anesthesia instead of brachial plexus block. Surgery, especially orthopedic surgery, attaches great importance to debridement. The basic principle of surgery is to completely remove contaminated and lifeless tissues, and this debridement is not operated at will.The X-ray film must be carefully studied before operation, and then combined with the specific situation of the palm to determine the scope of debridement and the length of bone shortening, because it is a broken operation. The broken palm is like a flesh colored rubber doll, without any blood color! On the ground, if you don't look carefully, you may be able to see the hand of a rubber doll!Because of the development of surgery, instrument nurses are becoming more and more important. A mature instrument nurse cannot skillfully cooperate with surgery without one or two years of training. Doctors perform surgery in different departments, but instrument nurses will not be divided into different departments. Therefore, instrument nurses must skillfully know the terms of all instruments and be proficient in surgical procedures.Because doctors do surgery, which step to do, instrument nurses have to prepare the instruments to be used in advance. If they are not familiar with the surgical steps, they will be unlucky to meet a doctor with a bad temper one day. They can directly throw away the surgical instruments ~!The older instrument nurses can tell at a glance what the doctor's level is. Therefore, young surgeons deliberately curry favor with some old nurses in the operating room because they can't tell what to say if they don't curry favor with them.The debridement of amputation surgery should be carried out by two doctors at the same time, so as to save time and win more time. Debridement must be carried out according to the anatomical level. While debridement, find the relevant nerves and blood vessels at the relevant level, so as to prepare for the next operation.For this simple debridement, the surgeon in charge must think about the steps, which to do first and which to do later, just like a war. The arrangement of troops before the war must be clear in his mind.The most important muscle of the palm is the thenar, which is unique to humans. Gorillas are genetically closest to humans, but these hairy animals don't have thenar, which is derived from the labor of human ancestors. Where is the thenar? It's the pimple muscle connected to the big finger.After muscle debridement, the next is the bone. In the palm bone, the most important thing is the metacarpophalangeal joint. This joint must be kept as complete as possible.Zhang Fan bowed his head and performed the operation with Lao Chen. Tong Lili's job is to ensure the clear vision of the operation. Generally speaking, it is to draw the hook and wipe the blood. Every surgeon comes here like this. First, he looks at the operation, which is the so-called third and fourth assistant. He wipes blood with a hook and sucks blood with a suction device. For one operation, he looks at it dozens of times, and then slowly boils up from the second assistant and the first assistant.This period of time has slowly opened the distance between some doctors. Surgery is a combination of talent and hard work. Some doctors deliberately train surgical skills after surgery. For example, they need to use some endoscopic techniques. When he comes home, he keeps training with two similar poles. A year can open a great distance, which is the difference between hard work and not hard work.If you pay attention, many surgeons often hold these things in their hands and keep playing. This is not boring to play, maybe they are training some surgical skills.After debridement, the broken bone should be repaired and fixed first. This is a matter of principle. After fixing the bone, there is the possibility of repairing other organs. The fracture is not fixed well. Move gently, and the newly repaired blood vessel pops and breaks again!After the fracture treatment, the muscle is repaired. If it is a broken injury, the surgeon's most hope is the sharp tool cutting injury, because it is easy to repair. If it is a rolling injury, it is estimated to be very troublesome. Maybe there is no chance to repair and amputate the limb directly.After the muscle repair, the blood vessel is completed. Zhang Fan and Chen Qifa began to operate under the microscope. The thick veins should be anastomosed as much as possible, which is the channel to ensure the blood return, and the arterial repair should be determined according to the situation. Radial ulnar artery is easy to do end-to-end anastomosis.Generally, the incidence of broken end in the palm is the highest and the survival rate after replantation is the lowest, which is related to the difficulty of revascularization.When the common finger artery is broken at the proper artery of two fingers at its distal end, it is troublesome. The main knife must be designed well, because a common artery can only be anastomosed with the proper artery of one finger. If the design is not good, one finger may lack direct blood supply. Then it leads to poor terminal circulation, which is particularly easy to cause some sequelae.In order to restore the function of the hand to the best state, the nerve must be repaired in one stage in principle. The disconnection of the sensory nerve, whether in the carpal tunnel or the palm, should be repaired in one stage. This is too important.The operation went on slowly and lost a little time. Because it was operated under a microscope, Tong Lili became more and more boring. Zhang Fan didn't know what they were doing. She couldn't see clearly.And it has been more than two hours. Originally, I was very tired after a sleepless night shift. Now I have stood for more than two hours. My legs are sore and my feet are numb. She can't stand it anymore. She has been gritting her teeth and insisting until now.Zhang Fan's operation was fast. In this way, it took three hours to suture the nerves. The later operation steps were simple. Zhang Fan and Lao Chen began to communicate, "today, you'll have more snacks and pay more attention to the blood supply of your hand.""Well, good master." Lao Chen nodded."Give some antibiotics routinely.""Well, OK.""Dr. Tong, which is the biggest complication of this replantation?" Zhang Fan wants to see if Tong Lili has a heart, so he asks fiercely."Well! Infection, necrosis? " Tong Lili said with a little uncertainty. After standing for more than three hours and the later operation was boring, she had a little brain wandering. Because she didn't distract a little, she really couldn't stand. As a result, Zhang fanmeng asked, she couldn't say."It is a vascular crisis, so the patients of this operation must not have smoking and in a smoking environment. Once a vascular crisis occurs, antispasmodic drugs must be used first. If it doesn't work, there will be a second operation! " Zhang Fan explained.A severed palm replantation is finished. Wrap it up. Zhang Fan stretched out his waist, looked at Tong Lili who was still standing by the operating table and said, "let's go! It's over. ""My legs are numb! I feel like I can't walk! " Tong Lili's voice is full of tears, not for leg numbness, but because she feels she can't adapt to this kind of work. It's not only boring, but also the operation time is too long.She was sad, sad and blamed herself. To tell the truth, if she didn't really like microsurgery, it would be really difficult for a weak woman to do it. Wang Yanan is a special case, because her hobby is her biggest motivation, while Tong Lili is different. She is to choose a good department. Departments that can not be marginalized.Life is so cruel, can not adapt, can not take down, can only let the virtuous, can only 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. When she stepped out of the operating room, Tong Lili insisted on tears for a long time and finally rolled down on the blue mask.I'd rather have hope than despair! Tong Lili can't find the meaning of being in the operating room! She's really frustrated! The pain in my heart is like the stirring of a knife!
