Chapter 346: 346
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"Start!" Liu Yaowen said dully. Because the hands are too polluted, we should disinfect them first. This kind of operation can't go wrong from the beginning, especially the disinfection, because skin grafting is necessary. Once there is infection, the transplanted skin may rot and necrosis. So disinfection here is too important.
Soapy water, Zhang Fan with gloves, brush on Wang Lao San's hands, blood and water with black oil, soap bubbles are all flowers, colorful under the shadowless lamp.
"Iodophor!" After washing with soapy water, he began to disinfect with Iodophor, and the fingernails of Wang Laosan's index finger and middle finger were directly stripped away. After disinfection, the subcutaneous tissue can be seen very clearly. Some white tendons have been broken, and some have been cut in half. Where the skin is thin, it is the bone directly.
"Baoyin, cut the remaining nails short." Zhang Fan explained to Baoyin.
"OK." Sometimes, the work of nurses is really hard to do. Tired don't say, still can't let the world understand.
In the past half a month, Zhang Fan's surgery volume, especially that of general surgery, has increased slightly. But in case of surgery, I didn't have any idea when I had surgery.
But after the operation, Zhang Fan looked at the operation progress of the system and was a little awkward. How to say, I don't want more surgery. It's a bit like duplicity. I want more surgery, but I don't have the heart. It's really awkward.
But in the case of surgery, although Zhang Fan was not happy, he was still very excited, as if the cells of the whole body were excited. This operation is the same as fitness. Now even if Zhang Fan doesn't have the system, he will refuel his liver, because this thing can be addictive.
Skin grafting, especially hand skin grafting, is very demanding. First of all, we should choose wear-resistant skin, because there are too many hand activities. If the skin is thin, it will be worn out. But also to ensure the functionality of the fingers.
"Dr. Lu, prepare the peeling knife. Baoyin, let's have two sheets. "
"OK." The two girls answered at the same time. Zhang Fan and Baoyin shop the sheet, and LV Shuyan prepares the peeling knife. This peeling knife, let alone peeling, can penetrate people in your hand.
This thing seems to have a bad breath by nature. The simplest one is that the blade is clamped between two iron bars, and one end of the iron bar is a rocker, which is cold and glittering. It is very sharp and close to the skin. When you shake it with your hand, the skin will be thin directly. You can have as thick and thin skin as you want.
"Start." Zhang Fan and LV Shuyan sat down face to face. Fortunately, they were hands. If the foot is so narrow, it is estimated that Zhang Fan and LV Shuyan will have to kneel for surgery.
"Doctor Zhang, let me pad you a piece of gauze." The itinerant nurse said and gently put a piece of gauze on Zhang Fan's forehead. The operating car is still small and the temperature is adjusted slowly.
The skin of Wang Lao San's two fingers was damaged. Other fingers were damaged intermittently, and the middle finger of the index finger was scratched directly by the wheel of the car.
"The middle finger is lost." Zhang Fan said to himself gently while gently pulling the muscle with tweezers to explore the damage.
"Isn't the bone intact?" LV Shuyan asked in wonder. During this time, she let Zhang Fan practice, and her Kung Fu has improved a lot. Now the girl is dead. I don't know if she's dead, but she already respects Zhang Fan.
"The bone is intact and good, but look at this muscle. The direct injury is a combination of scald and crush injury. The typical damage injury is that the central tendon bundle and lateral bundle are completely damaged. " Zhang Fan kept pointing to the damage with tweezers to explain to LV Shuyan.
This finger, the most classic human finger, is the muscle around the finger. It's so beautiful. If you go to a fresh autopsy, the muscles in other places don't look good. Pigs, horses, cattle, sheep and people are almost the same. It's just who has more and who has less.
Just this finger, only people have it. It's too classic. Open layer by layer, cut the interosseous muscle and vermis muscle, and directly show it in front of you like a fighter or a two handed sword in the middle ages.
All kinds of tendon bundles surround the extensor tendon, which is too complex. Simply speaking, several muscles are involved in the flexor or extensor muscle.
"Can't you fix it?" LV Shuyan asked naively. After all, she is not engaged in microsurgery. LV Shuyan doesn't know much about this aspect.
"This kind of injury is a doctor's nightmare. There is almost no complete organizational system. There is no way. Bury the stump! The index finger is still a little hopeful. In the future, the function of the hand is still complete. Start. " As they spoke, Zhang Fan and LV Shuyan bowed their heads and worked at the same time.
Repairing tendons and blood vessels is not a big thing. Under the guidance of Zhang Fan, LV Shuyan performed the operation painfully.
Originally, the noodles were a little hard, and then sour wind and fixed sitting posture for a long time. LV Shuyan's stomach was like a pain stirred together. The girl was really sweating, biting her teeth and cooperating with Zhang Fan without saying a word.
"Bone biting forceps!" Zhang Fan raised his head and said to Baoyin.
"Doctor Zhang, do you really want to bury the stump?" Baoyin had never been on the stage of hand trauma, so she asked curiously. After asking, she seemed a little rash and quickly bowed her head to pack up the equipment.
Although Zhang Fan didn't care, he explained: "shortening the injured finger is not necessarily worse than skin flap repair, especially in this case, combined with the patient's age, stump embedding is the best choice. Forcibly retain the length for the beauty of the fingers, and the fingers that lose function may still be a drag for the patients. "
"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's. This is the rules in the industry, not the rules.
After cleaning up the damage to his hand, the whole hand looks pleasing to the eye. The meat stuffing has been cleared and repaired by Zhang Fan. There has been such a thing.
"Peel!" Zhang Fan said in high spirits. Half of the long march has finally passed. LV Shuyan bit her teeth and almost shook when she stood up.
"What's the matter?" Zhang Fan looked at LV Shuyan and asked. His mask and hat were wrapped tightly, and he couldn't see each other's expression clearly.
"Nothing." LV Shuyan said in pain. Now even if it hurts, there's no way. Zhang fan can't do the operation alone. Other doctors and nurses can't help Zhang Fan even if they are on the stage. Because they are not surgeons, LV Shuyan can only be beaten hard now!
When the surgical towel leaving the hole was opened, Wang Laosan's white thigh leaked, and the leg hair was pushed clean. Looking at the surgical towel, I didn't know that it was a beautiful woman lying on the floor. It was too white.
Peeling, whether it is bare handed peeling or peeling with a peeling machine, should be close to the skin, pressed, and the spacing of blades should be adjusted. This spacing represents the thickness of peeling. Then, as the roller rotates bit by bit, the skin gently peels off like tofu skin.
The skin as like as two peas is pulled out of the skin without any subcutaneous tissue. After the leather surface of the table tennis racket is pulled out, there are dots or yellow or red dots on it.
Skin is also as like as two peas. The skins inside the skinned knives are lined with little fat particles or hair follicles, almost identical. Of course, doctors with poor skills peel off different thickness of skin.
Zhang Fan's technology is home. A piece of skin is covered with a shadowless lamp. The four sides are almost the same thickness.
"Beautiful!" Zhang Fan couldn't help praising himself. Cruel art.
"No shame!" Zhang Fan opened his mouth and the operating car was alive. Everyone began to talk. Baoyin smiled and whispered a joke.
"Our hospital skinning Zhang Fan is the first, ha ha!" Liu Yaowen said with a smile while adding anesthetics that the operation time is too long. Without adding a little, the patient can wake up with pain.
"Hehe! Warm saline gauze. " Zhang Fan ended the chat. After gently wiping the peeled soft tissue with saline gauze, the operation time was too tight to deal with it carefully. Zhang Fan directly electrocoagulated the larger bleeding. Then the big needle and thread pulled up the skin and sewed it together.
In many operations, the skin suture of patients is very rough and not meticulous at all. It feels like fooling people. In fact, this is to prevent necrosis. The small needle and fine thread are beautiful and can easily lead to necrosis due to ischemia. Fortunately, the wound is on the thigh. It doesn't matter. The old man doesn't wear super short!
The peeled skin was half the size of an A4 paper. Zhang Fan took it in his hand and put it on the affected hand. After gently comparing it, he said to Baoyin, "sharp knife."
And said to LV Shuyan, "fixed." LV Shuyan didn't have skin grafting. She didn't understand very well. She was stunned for a moment and asked embarrassed, "how to fix it."
"The four corners are leveled and fixed with Alice pliers!" Zhang Fan is a little impatient, but he wants to be the same when he thinks about it. He is a gynecologist, not an orthopaedic, not a general foreigner!
Then he added: "we must stretch, otherwise there will be deviation in positioning."
Lv Shu's face turned red. Although she shouted again in her heart, "my mother's stomach has become a lump. You still hurt me. I'm a gynecologist, I'm a gynecologist!" But I just shouted in my heart. Who made her a doctor and who made her an surgeon.
After fixing, Zhang Fan started embroidery with a knife. Yes, embroidery. Because of the avulsion injury, there is no skin left on the surface of the finger. If you want the transplanted skin to survive, you have to make a glove for it.
After selecting the position, Zhang Fan began to draw several small holes on the stripped skin with a knife. The hole should pass through his fingers, not too big or too small.
The subcutaneous tissue will leak out if it is too large and too small for blood circulation, so it is very exquisite. Moreover, this skin graft is just this one. There can be no mistakes. If there are mistakes, we can only graft again! Is it possible to have another skin graft? impossible. So Zhang Fan is very careful.
When the hole was completed, Zhang Fan breathed a sigh of relief. Although this is a small detail, this small detail is very key, which 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 LV Shuyan.
"The size should be OK. It's almost the same at a glance." Liu Yaowen couldn't help but put in a word.
Baoyin was very boring. Lao Liu spoke. She hurriedly asked, "what you can, you can see the size at a glance?"
"Hehe, in fact, I have more research on depth!" The old man said without shame.
"Hooligans." Baoyin doesn't know whether it's a shy smile and scold. So does she. She knows that she's an old man and loves to flirt.
Zhang Fan grabbed both ends of the stripped skin. When unfolded, the skin is extensible and contractile. Without force, it can shrink the skin.
LV Shuyan grabbed the two fingers of Wang Laosan, standing straight, gently, bit by bit. With a little friction, Zhang Fan covered his skin.
“OK！ The size is appropriate. " Zhang Fan said easily after looking at the gap.
"Look, I'm right!" Lao Liu said with a smile. Baoyin ignored him again.
Set the fingers, Zhang Fan covered the skin on the back of his hand and fingers, and then cut the skin into strips at his fingers, and then wrapped the strip around Wang Laosan's two fingers in a spiral.
"Stitch." At Zhang Fan's command, several people moved. The anesthesiologist was ready to wake up. The nurse put on the needle, and LV Shuyan took scissors to cut the thread and tie the knot.
The operation time of a hand is almost longer than that of a femoral fracture, because the muscle division of the hand is too detailed. If it is done a little carelessly, the patient's finger function will have problems after operation.
Suture, pressure bandage, the operation is over“ We must pay attention to infection after operation. It's not possible here. It's estimated that we have to send it to the county hospital. " Zhang Fan said and bandaged.
Finally, Zhang Fan began to tie gauze. LV Shuyan staggered and fell, "plop!" All of a sudden, the girl fell on the operating table.
"I'll go!" Zhang Fan was surprised. Immediately put Wang Laosan's hand on his chest and said to Baoyin, "hold it!"
Baoyin immediately grabbed Wang Laosan's hand. Zhang Fan rushed over and pulled off LV Shuyan's mask. At a glance, the girl clenched her teeth and looked like pain on her face.
"What's the matter?" Then he put his hand into LV Shuyan's clothes.
Zhang Fan didn't go to get cheap, but to touch the girl's carotid artery. LV Shuyan's painful appearance frightened Zhang Fan into thinking that she had a heart attack.
"It's all right! I'm fine. It's just a stomachache. I feel a little uncomfortable and dizzy after standing for a long time. " Slightly relieved for a while, LV Shuyan opened her eyes and said weakly.
"Are you sure. Let me give you a physical examination. " Zhang Fan said.
"Well! No, I'm really fine. " As soon as Zhang Fan wanted to check his body, LV Shuyan's blue face floated a faint blush. Physical examination, abdominal physical examination is to lift her stomach. She's shy.
"Oh, I'm scared to death. Go back and lie down for a while. If you don't wake up again, Zhang Fan will probably give you artificial respiration. " Lao Liu was not lightly frightened. Although he said it easily, the horror on his face had not disappeared.
"Come on, hurry up. Come and give her a hand. I'll carry her down." Zhang Fan ignored his laipi words and said something to Lao Liu.
Wang Laosan was pushed down, LV Shuyan was carried down, and the five hour operation was over!
Please report us if you find any errors so we can fix it asap!
"Start!" Liu Yaowen said dully. Because the hands are too polluted, we should disinfect them first. This kind of operation can't go wrong from the beginning, especially the disinfection, because skin grafting is necessary. Once there is infection, the transplanted skin may rot and necrosis. So disinfection here is too important.
Soapy water, Zhang Fan with gloves, brush on Wang Lao San's hands, blood and water with black oil, soap bubbles are all flowers, colorful under the shadowless lamp.
"Iodophor!" After washing with soapy water, he began to disinfect with Iodophor, and the fingernails of Wang Laosan's index finger and middle finger were directly stripped away. After disinfection, the subcutaneous tissue can be seen very clearly. Some white tendons have been broken, and some have been cut in half. Where the skin is thin, it is the bone directly.
"Baoyin, cut the remaining nails short." Zhang Fan explained to Baoyin.
"OK." Sometimes, the work of nurses is really hard to do. Tired don't say, still can't let the world understand.
In the past half a month, Zhang Fan's surgery volume, especially that of general surgery, has increased slightly. But in case of surgery, I didn't have any idea when I had surgery.
But after the operation, Zhang Fan looked at the operation progress of the system and was a little awkward. How to say, I don't want more surgery. It's a bit like duplicity. I want more surgery, but I don't have the heart. It's really awkward.
But in the case of surgery, although Zhang Fan was not happy, he was still very excited, as if the cells of the whole body were excited. This operation is the same as fitness. Now even if Zhang Fan doesn't have the system, he will refuel his liver, because this thing can be addictive.
Skin grafting, especially hand skin grafting, is very demanding. First of all, we should choose wear-resistant skin, because there are too many hand activities. If the skin is thin, it will be worn out. But also to ensure the functionality of the fingers.
"Dr. Lu, prepare the peeling knife. Baoyin, let's have two sheets. "
"OK." The two girls answered at the same time. Zhang Fan and Baoyin shop the sheet, and LV Shuyan prepares the peeling knife. This peeling knife, let alone peeling, can penetrate people in your hand.
This thing seems to have a bad breath by nature. The simplest one is that the blade is clamped between two iron bars, and one end of the iron bar is a rocker, which is cold and glittering. It is very sharp and close to the skin. When you shake it with your hand, the skin will be thin directly. You can have as thick and thin skin as you want.
"Start." Zhang Fan and LV Shuyan sat down face to face. Fortunately, they were hands. If the foot is so narrow, it is estimated that Zhang Fan and LV Shuyan will have to kneel for surgery.
"Doctor Zhang, let me pad you a piece of gauze." The itinerant nurse said and gently put a piece of gauze on Zhang Fan's forehead. The operating car is still small and the temperature is adjusted slowly.
The skin of Wang Lao San's two fingers was damaged. Other fingers were damaged intermittently, and the middle finger of the index finger was scratched directly by the wheel of the car.
"The middle finger is lost." Zhang Fan said to himself gently while gently pulling the muscle with tweezers to explore the damage.
"Isn't the bone intact?" LV Shuyan asked in wonder. During this time, she let Zhang Fan practice, and her Kung Fu has improved a lot. Now the girl is dead. I don't know if she's dead, but she already respects Zhang Fan.
"The bone is intact and good, but look at this muscle. The direct injury is a combination of scald and crush injury. The typical damage injury is that the central tendon bundle and lateral bundle are completely damaged. " Zhang Fan kept pointing to the damage with tweezers to explain to LV Shuyan.
This finger, the most classic human finger, is the muscle around the finger. It's so beautiful. If you go to a fresh autopsy, the muscles in other places don't look good. Pigs, horses, cattle, sheep and people are almost the same. It's just who has more and who has less.
Just this finger, only people have it. It's too classic. Open layer by layer, cut the interosseous muscle and vermis muscle, and directly show it in front of you like a fighter or a two handed sword in the middle ages.
All kinds of tendon bundles surround the extensor tendon, which is too complex. Simply speaking, several muscles are involved in the flexor or extensor muscle.
"Can't you fix it?" LV Shuyan asked naively. After all, she is not engaged in microsurgery. LV Shuyan doesn't know much about this aspect.
"This kind of injury is a doctor's nightmare. There is almost no complete organizational system. There is no way. Bury the stump! The index finger is still a little hopeful. In the future, the function of the hand is still complete. Start. " As they spoke, Zhang Fan and LV Shuyan bowed their heads and worked at the same time.
Repairing tendons and blood vessels is not a big thing. Under the guidance of Zhang Fan, LV Shuyan performed the operation painfully.
Originally, the noodles were a little hard, and then sour wind and fixed sitting posture for a long time. LV Shuyan's stomach was like a pain stirred together. The girl was really sweating, biting her teeth and cooperating with Zhang Fan without saying a word.
"Bone biting forceps!" Zhang Fan raised his head and said to Baoyin.
"Doctor Zhang, do you really want to bury the stump?" Baoyin had never been on the stage of hand trauma, so she asked curiously. After asking, she seemed a little rash and quickly bowed her head to pack up the equipment.
Although Zhang Fan didn't care, he explained: "shortening the injured finger is not necessarily worse than skin flap repair, especially in this case, combined with the patient's age, stump embedding is the best choice. Forcibly retain the length for the beauty of the fingers, and the fingers that lose function may still be a drag for the patients. "
"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's. This is the rules in the industry, not the rules.
After cleaning up the damage to his hand, the whole hand looks pleasing to the eye. The meat stuffing has been cleared and repaired by Zhang Fan. There has been such a thing.
"Peel!" Zhang Fan said in high spirits. Half of the long march has finally passed. LV Shuyan bit her teeth and almost shook when she stood up.
"What's the matter?" Zhang Fan looked at LV Shuyan and asked. His mask and hat were wrapped tightly, and he couldn't see each other's expression clearly.
"Nothing." LV Shuyan said in pain. Now even if it hurts, there's no way. Zhang fan can't do the operation alone. Other doctors and nurses can't help Zhang Fan even if they are on the stage. Because they are not surgeons, LV Shuyan can only be beaten hard now!
When the surgical towel leaving the hole was opened, Wang Laosan's white thigh leaked, and the leg hair was pushed clean. Looking at the surgical towel, I didn't know that it was a beautiful woman lying on the floor. It was too white.
Peeling, whether it is bare handed peeling or peeling with a peeling machine, should be close to the skin, pressed, and the spacing of blades should be adjusted. This spacing represents the thickness of peeling. Then, as the roller rotates bit by bit, the skin gently peels off like tofu skin.
The skin as like as two peas is pulled out of the skin without any subcutaneous tissue. After the leather surface of the table tennis racket is pulled out, there are dots or yellow or red dots on it.
Skin is also as like as two peas. The skins inside the skinned knives are lined with little fat particles or hair follicles, almost identical. Of course, doctors with poor skills peel off different thickness of skin.
Zhang Fan's technology is home. A piece of skin is covered with a shadowless lamp. The four sides are almost the same thickness.
"Beautiful!" Zhang Fan couldn't help praising himself. Cruel art.
"No shame!" Zhang Fan opened his mouth and the operating car was alive. Everyone began to talk. Baoyin smiled and whispered a joke.
"Our hospital skinning Zhang Fan is the first, ha ha!" Liu Yaowen said with a smile while adding anesthetics that the operation time is too long. Without adding a little, the patient can wake up with pain.
"Hehe! Warm saline gauze. " Zhang Fan ended the chat. After gently wiping the peeled soft tissue with saline gauze, the operation time was too tight to deal with it carefully. Zhang Fan directly electrocoagulated the larger bleeding. Then the big needle and thread pulled up the skin and sewed it together.
In many operations, the skin suture of patients is very rough and not meticulous at all. It feels like fooling people. In fact, this is to prevent necrosis. The small needle and fine thread are beautiful and can easily lead to necrosis due to ischemia. Fortunately, the wound is on the thigh. It doesn't matter. The old man doesn't wear super short!
The peeled skin was half the size of an A4 paper. Zhang Fan took it in his hand and put it on the affected hand. After gently comparing it, he said to Baoyin, "sharp knife."
And said to LV Shuyan, "fixed." LV Shuyan didn't have skin grafting. She didn't understand very well. She was stunned for a moment and asked embarrassed, "how to fix it."
"The four corners are leveled and fixed with Alice pliers!" Zhang Fan is a little impatient, but he wants to be the same when he thinks about it. He is a gynecologist, not an orthopaedic, not a general foreigner!
Then he added: "we must stretch, otherwise there will be deviation in positioning."
Lv Shu's face turned red. Although she shouted again in her heart, "my mother's stomach has become a lump. You still hurt me. I'm a gynecologist, I'm a gynecologist!" But I just shouted in my heart. Who made her a doctor and who made her an surgeon.
After fixing, Zhang Fan started embroidery with a knife. Yes, embroidery. Because of the avulsion injury, there is no skin left on the surface of the finger. If you want the transplanted skin to survive, you have to make a glove for it.
After selecting the position, Zhang Fan began to draw several small holes on the stripped skin with a knife. The hole should pass through his fingers, not too big or too small.
The subcutaneous tissue will leak out if it is too large and too small for blood circulation, so it is very exquisite. Moreover, this skin graft is just this one. There can be no mistakes. If there are mistakes, we can only graft again! Is it possible to have another skin graft? impossible. So Zhang Fan is very careful.
When the hole was completed, Zhang Fan breathed a sigh of relief. Although this is a small detail, this small detail is very key, which 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 LV Shuyan.
"The size should be OK. It's almost the same at a glance." Liu Yaowen couldn't help but put in a word.
Baoyin was very boring. Lao Liu spoke. She hurriedly asked, "what you can, you can see the size at a glance?"
"Hehe, in fact, I have more research on depth!" The old man said without shame.
"Hooligans." Baoyin doesn't know whether it's a shy smile and scold. So does she. She knows that she's an old man and loves to flirt.
Zhang Fan grabbed both ends of the stripped skin. When unfolded, the skin is extensible and contractile. Without force, it can shrink the skin.
LV Shuyan grabbed the two fingers of Wang Laosan, standing straight, gently, bit by bit. With a little friction, Zhang Fan covered his skin.
“OK！ The size is appropriate. " Zhang Fan said easily after looking at the gap.
"Look, I'm right!" Lao Liu said with a smile. Baoyin ignored him again.
Set the fingers, Zhang Fan covered the skin on the back of his hand and fingers, and then cut the skin into strips at his fingers, and then wrapped the strip around Wang Laosan's two fingers in a spiral.
"Stitch." At Zhang Fan's command, several people moved. The anesthesiologist was ready to wake up. The nurse put on the needle, and LV Shuyan took scissors to cut the thread and tie the knot.
The operation time of a hand is almost longer than that of a femoral fracture, because the muscle division of the hand is too detailed. If it is done a little carelessly, the patient's finger function will have problems after operation.
Suture, pressure bandage, the operation is over“ We must pay attention to infection after operation. It's not possible here. It's estimated that we have to send it to the county hospital. " Zhang Fan said and bandaged.
Finally, Zhang Fan began to tie gauze. LV Shuyan staggered and fell, "plop!" All of a sudden, the girl fell on the operating table.
"I'll go!" Zhang Fan was surprised. Immediately put Wang Laosan's hand on his chest and said to Baoyin, "hold it!"
Baoyin immediately grabbed Wang Laosan's hand. Zhang Fan rushed over and pulled off LV Shuyan's mask. At a glance, the girl clenched her teeth and looked like pain on her face.
"What's the matter?" Then he put his hand into LV Shuyan's clothes.
Zhang Fan didn't go to get cheap, but to touch the girl's carotid artery. LV Shuyan's painful appearance frightened Zhang Fan into thinking that she had a heart attack.
"It's all right! I'm fine. It's just a stomachache. I feel a little uncomfortable and dizzy after standing for a long time. " Slightly relieved for a while, LV Shuyan opened her eyes and said weakly.
"Are you sure. Let me give you a physical examination. " Zhang Fan said.
"Well! No, I'm really fine. " As soon as Zhang Fan wanted to check his body, LV Shuyan's blue face floated a faint blush. Physical examination, abdominal physical examination is to lift her stomach. She's shy.
"Oh, I'm scared to death. Go back and lie down for a while. If you don't wake up again, Zhang Fan will probably give you artificial respiration. " Lao Liu was not lightly frightened. Although he said it easily, the horror on his face had not disappeared.
"Come on, hurry up. Come and give her a hand. I'll carry her down." Zhang Fan ignored his laipi words and said something to Lao Liu.
Wang Laosan was pushed down, LV Shuyan was carried down, and the five hour operation was over!
"Start!" Liu Yaowen said dully. Because the hands are too polluted, we should disinfect them first. This kind of operation can't go wrong from the beginning, especially the disinfection, because skin grafting is necessary. Once there is infection, the transplanted skin may rot and necrosis. So disinfection here is too important.Soapy water, Zhang Fan with gloves, brush on Wang Lao San's hands, blood and water with black oil, soap bubbles are all flowers, colorful under the shadowless lamp."Iodophor!" After washing with soapy water, he began to disinfect with Iodophor, and the fingernails of Wang Laosan's index finger and middle finger were directly stripped away. After disinfection, the subcutaneous tissue can be seen very clearly. Some white tendons have been broken, and some have been cut in half. Where the skin is thin, it is the bone directly."Baoyin, cut the remaining nails short." Zhang Fan explained to Baoyin."OK." Sometimes, the work of nurses is really hard to do. Tired don't say, still can't let the world understand.In the past half a month, Zhang Fan's surgery volume, especially that of general surgery, has increased slightly. But in case of surgery, I didn't have any idea when I had surgery.But after the operation, Zhang Fan looked at the operation progress of the system and was a little awkward. How to say, I don't want more surgery. It's a bit like duplicity. I want more surgery, but I don't have the heart. It's really awkward.But in the case of surgery, although Zhang Fan was not happy, he was still very excited, as if the cells of the whole body were excited. This operation is the same as fitness. Now even if Zhang Fan doesn't have the system, he will refuel his liver, because this thing can be addictive.Skin grafting, especially hand skin grafting, is very demanding. First of all, we should choose wear-resistant skin, because there are too many hand activities. If the skin is thin, it will be worn out. But also to ensure the functionality of the fingers."Dr. Lu, prepare the peeling knife. Baoyin, let's have two sheets. ""OK." The two girls answered at the same time. Zhang Fan and Baoyin shop the sheet, and LV Shuyan prepares the peeling knife. This peeling knife, let alone peeling, can penetrate people in your hand.This thing seems to have a bad breath by nature. The simplest one is that the blade is clamped between two iron bars, and one end of the iron bar is a rocker, which is cold and glittering. It is very sharp and close to the skin. When you shake it with your hand, the skin will be thin directly. You can have as thick and thin skin as you want."Start." Zhang Fan and LV Shuyan sat down face to face. Fortunately, they were hands. If the foot is so narrow, it is estimated that Zhang Fan and LV Shuyan will have to kneel for surgery."Doctor Zhang, let me pad you a piece of gauze." The itinerant nurse said and gently put a piece of gauze on Zhang Fan's forehead. The operating car is still small and the temperature is adjusted slowly.The skin of Wang Lao San's two fingers was damaged. Other fingers were damaged intermittently, and the middle finger of the index finger was scratched directly by the wheel of the car."The middle finger is lost." Zhang Fan said to himself gently while gently pulling the muscle with tweezers to explore the damage."Isn't the bone intact?" LV Shuyan asked in wonder. During this time, she let Zhang Fan practice, and her Kung Fu has improved a lot. Now the girl is dead. I don't know if she's dead, but she already respects Zhang Fan."The bone is intact and good, but look at this muscle. The direct injury is a combination of scald and crush injury. The typical damage injury is that the central tendon bundle and lateral bundle are completely damaged. " Zhang Fan kept pointing to the damage with tweezers to explain to LV Shuyan.This finger, the most classic human finger, is the muscle around the finger. It's so beautiful. If you go to a fresh autopsy, the muscles in other places don't look good. Pigs, horses, cattle, sheep and people are almost the same. It's just who has more and who has less.Just this finger, only people have it. It's too classic. Open layer by layer, cut the interosseous muscle and vermis muscle, and directly show it in front of you like a fighter or a two handed sword in the middle ages.All kinds of tendon bundles surround the extensor tendon, which is too complex. Simply speaking, several muscles are involved in the flexor or extensor muscle."Can't you fix it?" LV Shuyan asked naively. After all, she is not engaged in microsurgery. LV Shuyan doesn't know much about this aspect."This kind of injury is a doctor's nightmare. There is almost no complete organizational system. There is no way. Bury the stump! The index finger is still a little hopeful. In the future, the function of the hand is still complete. Start. " As they spoke, Zhang Fan and LV Shuyan bowed their heads and worked at the same time.Repairing tendons and blood vessels is not a big thing. Under the guidance of Zhang Fan, LV Shuyan performed the operation painfully.Originally, the noodles were a little hard, and then sour wind and fixed sitting posture for a long time. LV Shuyan's stomach was like a pain stirred together. The girl was really sweating, biting her teeth and cooperating with Zhang Fan without saying a word."Bone biting forceps!" Zhang Fan raised his head and said to Baoyin."Doctor Zhang, do you really want to bury the stump?" Baoyin had never been on the stage of hand trauma, so she asked curiously. After asking, she seemed a little rash and quickly bowed her head to pack up the equipment.Although Zhang Fan didn't care, he explained: "shortening the injured finger is not necessarily worse than skin flap repair, especially in this case, combined with the patient's age, stump embedding is the best choice. Forcibly retain the length for the beauty of the fingers, and the fingers that lose function may still be a drag for the patients. ""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's. This is the rules in the industry, not the rules.After cleaning up the damage to his hand, the whole hand looks pleasing to the eye. The meat stuffing has been cleared and repaired by Zhang Fan. There has been such a thing."Peel!" Zhang Fan said in high spirits. Half of the long march has finally passed. LV Shuyan bit her teeth and almost shook when she stood up."What's the matter?" Zhang Fan looked at LV Shuyan and asked. His mask and hat were wrapped tightly, and he couldn't see each other's expression clearly."Nothing." LV Shuyan said in pain. Now even if it hurts, there's no way. Zhang fan can't do the operation alone. Other doctors and nurses can't help Zhang Fan even if they are on the stage. Because they are not surgeons, LV Shuyan can only be beaten hard now!When the surgical towel leaving the hole was opened, Wang Laosan's white thigh leaked, and the leg hair was pushed clean. Looking at the surgical towel, I didn't know that it was a beautiful woman lying on the floor. It was too white.Peeling, whether it is bare handed peeling or peeling with a peeling machine, should be close to the skin, pressed, and the spacing of blades should be adjusted. This spacing represents the thickness of peeling. Then, as the roller rotates bit by bit, the skin gently peels off like tofu skin.The skin as like as two peas is pulled out of the skin without any subcutaneous tissue. After the leather surface of the table tennis racket is pulled out, there are dots or yellow or red dots on it.Skin is also as like as two peas. The skins inside the skinned knives are lined with little fat particles or hair follicles, almost identical. Of course, doctors with poor skills peel off different thickness of skin.Zhang Fan's technology is home. A piece of skin is covered with a shadowless lamp. The four sides are almost the same thickness."Beautiful!" Zhang Fan couldn't help praising himself. Cruel art."No shame!" Zhang Fan opened his mouth and the operating car was alive. Everyone began to talk. Baoyin smiled and whispered a joke."Our hospital skinning Zhang Fan is the first, ha ha!" Liu Yaowen said with a smile while adding anesthetics that the operation time is too long. Without adding a little, the patient can wake up with pain."Hehe! Warm saline gauze. " Zhang Fan ended the chat. After gently wiping the peeled soft tissue with saline gauze, the operation time was too tight to deal with it carefully. Zhang Fan directly electrocoagulated the larger bleeding. Then the big needle and thread pulled up the skin and sewed it together.In many operations, the skin suture of patients is very rough and not meticulous at all. It feels like fooling people. In fact, this is to prevent necrosis. The small needle and fine thread are beautiful and can easily lead to necrosis due to ischemia. Fortunately, the wound is on the thigh. It doesn't matter. The old man doesn't wear super short!The peeled skin was half the size of an A4 paper. Zhang Fan took it in his hand and put it on the affected hand. After gently comparing it, he said to Baoyin, "sharp knife."And said to LV Shuyan, "fixed." LV Shuyan didn't have skin grafting. She didn't understand very well. She was stunned for a moment and asked embarrassed, "how to fix it.""The four corners are leveled and fixed with Alice pliers!" Zhang Fan is a little impatient, but he wants to be the same when he thinks about it. He is a gynecologist, not an orthopaedic, not a general foreigner!Then he added: "we must stretch, otherwise there will be deviation in positioning."Lv Shu's face turned red. Although she shouted again in her heart, "my mother's stomach has become a lump. You still hurt me. I'm a gynecologist, I'm a gynecologist!" But I just shouted in my heart. Who made her a doctor and who made her an surgeon.After fixing, Zhang Fan started embroidery with a knife. Yes, embroidery. Because of the avulsion injury, there is no skin left on the surface of the finger. If you want the transplanted skin to survive, you have to make a glove for it.After selecting the position, Zhang Fan began to draw several small holes on the stripped skin with a knife. The hole should pass through his fingers, not too big or too small.The subcutaneous tissue will leak out if it is too large and too small for blood circulation, so it is very exquisite. Moreover, this skin graft is just this one. There can be no mistakes. If there are mistakes, we can only graft again! Is it possible to have another skin graft? impossible. So Zhang Fan is very careful.When the hole was completed, Zhang Fan breathed a sigh of relief. Although this is a small detail, this small detail is very key, which 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 LV Shuyan."The size should be OK. It's almost the same at a glance." Liu Yaowen couldn't help but put in a word.Baoyin was very boring. Lao Liu spoke. She hurriedly asked, "what you can, you can see the size at a glance?""Hehe, in fact, I have more research on depth!" The old man said without shame."Hooligans." Baoyin doesn't know whether it's a shy smile and scold. So does she. She knows that she's an old man and loves to flirt.Zhang Fan grabbed both ends of the stripped skin. When unfolded, the skin is extensible and contractile. Without force, it can shrink the skin.LV Shuyan grabbed the two fingers of Wang Laosan, standing straight, gently, bit by bit. With a little friction, Zhang Fan covered his skin.OK The size is appropriate. " Zhang Fan said easily after looking at the gap."Look, I'm right!" Lao Liu said with a smile. Baoyin ignored him again.Set the fingers, Zhang Fan covered the skin on the back of his hand and fingers, and then cut the skin into strips at his fingers, and then wrapped the strip around Wang Laosan's two fingers in a spiral."Stitch." At Zhang Fan's command, several people moved. The anesthesiologist was ready to wake up. The nurse put on the needle, and LV Shuyan took scissors to cut the thread and tie the knot.The operation time of a hand is almost longer than that of a femoral fracture, because the muscle division of the hand is too detailed. If it is done a little carelessly, the patient's finger function will have problems after operation.Suture, pressure bandage, the operation is over We must pay attention to infection after operation. It's not possible here. It's estimated that we have to send it to the county hospital. " Zhang Fan said and bandaged.Finally, Zhang Fan began to tie gauze. LV Shuyan staggered and fell, "plop!" All of a sudden, the girl fell on the operating table."I'll go!" Zhang Fan was surprised. Immediately put Wang Laosan's hand on his chest and said to Baoyin, "hold it!"Baoyin immediately grabbed Wang Laosan's hand. Zhang Fan rushed over and pulled off LV Shuyan's mask. At a glance, the girl clenched her teeth and looked like pain on her face."What's the matter?" Then he put his hand into LV Shuyan's clothes.Zhang Fan didn't go to get cheap, but to touch the girl's carotid artery. LV Shuyan's painful appearance frightened Zhang Fan into thinking that she had a heart attack."It's all right! I'm fine. It's just a stomachache. I feel a little uncomfortable and dizzy after standing for a long time. " Slightly relieved for a while, LV Shuyan opened her eyes and said weakly."Are you sure. Let me give you a physical examination. " Zhang Fan said."Well! No, I'm really fine. " As soon as Zhang Fan wanted to check his body, LV Shuyan's blue face floated a faint blush. Physical examination, abdominal physical examination is to lift her stomach. She's shy."Oh, I'm scared to death. Go back and lie down for a while. If you don't wake up again, Zhang Fan will probably give you artificial respiration. " Lao Liu was not lightly frightened. Although he said it easily, the horror on his face had not disappeared."Come on, hurry up. Come and give her a hand. I'll carry her down." Zhang Fan ignored his laipi words and said something to Lao Liu.Wang Laosan was pushed down, LV Shuyan was carried down, and the five hour operation was over!
