It is also debridement and suture, but the debridement and suture for replantation of severed fingers is much more high-end.
Lu Wenbin dealt with the severed finger on one side, while Ling Ran worked on the other end with the help of Ma Yanlin.
The three of them lowered their heads and wore microscope glasses, treating the wounds one by one.
Compared with ordinary debridement and suture, debridement and suture for replantation of amputated fingers can be done cleanly without losing too much tissue, and the latter is the most troublesome. If too much skin is cut, flaps need to be transplanted, if too much tendon is cut, too many blood vessels are shaved, the same is true.
Lu Wenbin also followed Ling Ran through more than a hundred cases of tang before he was qualified to do the debridement of severed fingers alone. This is also the easiest step in suturing a severed finger.
After the debridement was completed, Ling Ran fixed the bones and joints again, and then used the internal fixation nails provided by Changxi Pharmaceutical Company to lock the anastomotic joints. After some operations, 40 minutes had passed.
Ling Ran raised his neck and rested for a few seconds before someone pulled the high-precision microscope over.
The high-precision microscope used by Cloud Medical is like a huge desk lamp with four wheels under its feet. The lamp head is the main part of the microscope. The body is heavy and the magnification is enough to clearly see the tiny blood vessels and nerve fibers in the brain.
The replantation of amputated fingers can be done with ordinary microscopes, but it is a little more laborious. In fact, the early replantation of severed fingers was often performed without a microscope. In the 21st century, some small hospitals in some places still perform replantation of severed fingers with the naked eye.
Ling Ran couldn't bear the roughness of blood vessel anastomosis with the naked eye.
If the conditions are not met, he can bear with it, but under the conditions, Ling Ran will not feel too refreshed when he sees that the 24 stitches are not aligned.
Master-level sutures, if the stitches are still uneven under the microscope, it will be even more uncomfortable.
Therefore, even though Ling Ran had just started replanting severed fingers, he needed a high-precision microscope first. A price of one million yuan is considered the treasure of the town in a private hospital, but it is just ordinary in Yunhua Hospital. Huo Congjun said hello and moved one over.
Of course, this is what Ling Ran wants to use, and it is indeed useful. If you change the request of an attending doctor, it will not be so easy to talk about.
Ling Ran kicked a round stool over, then sat on the round stool, and began to manipulate the patient's severed finger through the lamp-like microscope.
He first stitches up the most familiar tendons. Compared with the tang method, the tendon suture for replantation of severed fingers is much simpler. After all, there is no problem with the tendon sheath of the flexor tendon, and postoperative adhesions are also easier to deal with.
In less than 20 minutes, Ling Ran sutured the tendon extremely slowly.
Most of this process is for him to familiarize himself with the equipment. Although he has practiced many times before, he still needs to be cautious when actually getting started.
"Looking at the length of the blood vessels, it should be a direct fit." Ling Ran made a judgment and made a decision.
It is also the case of replantation of severed limbs. If the length of the blood vessels is sufficient, anastomosis of blood vessels can be performed. If the length is not enough, vascular reconstruction, that is, vascular transplantation, is required. It is naturally much more difficult to cut a section of blood vessel from the patient's body and suture it.
This is also one of the reasons why debridement and sutures are done very carefully.
For a blood vessel anastomosis, Ling Ran took half an hour to complete it slowly.
On the one hand, he did not deliberately pursue the speed, but also deliberately slowed down to ensure the fineness of the stitches. On the other hand, the blood vessels of the severed finger are indeed small, and each stitch must be fully prepared. A successful one will not bring pressure. Small.
After one blood vessel was sutured, Ling Ran's forehead was covered with fine beads of sweat.
"Is there no problem?" Huo Congjun's voice sounded from behind, startling Ling Ran.
Looking back, I saw Huo Congjun wearing a white coat, hands behind his back, smiling like an old man walking a bird.
"There is no problem with the operation." Ling Ran gave Huo Congjun a strange look, and asked, "What happened?"
"Where are there so many accidents?" Huo Congjun shook his head and said, "What's the matter, you are allowed to have surgery at three o'clock in the morning, but you are not allowed to come to the operating room at five o'clock?"
"The surgery is still in your name." Ling Ran said indifferently.
"As long as you remember, so, how was today's operation?" Huo Congjun said, picked up a round stool from behind, and put it under his buttocks.
Su Jiafu clenched his hands tightly together, full of indignation: the anesthesiologist also snatched the stool, what about human nature
"Do another nerve anastomosis, and it's almost done." Ling Ran gave a brief introduction, and then continued to operate.
Huo Congjun said again: "I heard from the nurse that the patient has been smoking for 15 years?"
"yes."
"Do you think the patient will quit smoking?"
"have no idea."
"So, do you think it doesn't matter whether the patient quits smoking?"
"Basically." Ling Ran put both eyes on the eyepiece, and said, "I can't just make a decision for someone just because I sewed up one of his fingers."
Huo Congjun was stunned for a few seconds, then he laughed out loud.
Ling Ran glanced back and continued to operate.
Huo Congjun didn't leave, just stared at Ling Ran's operations from behind, not knowing what he was thinking.
At seven o'clock in the morning, Ling Ran just announced that the operation was completed.
Huo Congjun stood up after him, thoughtfully, but said: "Now there is a child's severed finger replantation operation, would you like to participate?"
Ling Ran looked at Huo Congjun puzzled, "What do you mean?"
"A 5-year-old child had 8 fingers broken by the automatic door of the hotel, and he has been sent to the hand surgery department of our hospital." Huo Congjun paused for a while, and said: "The hand surgery plan will open four groups at the same time, and cooperate to perform finger amputation. Zaizhi, if you are willing to participate, you can prepare now."
The amount of information in Huo Congjun's words was too large, and it took Ling Ran a while to react, and then asked: "Is the eight fingers squeezed? Completely severed or not completely severed? For four groups, each Make two fingers?"
"Yes, not completely separated, yes." Huo Congjun answered briefly.
"Will the hand surgery department let me join?" Ling Ran asked another key question.
Huo Congjun said calmly: "They are not enough."
"There are no fewer doctors in hand surgery than our emergency department."
"There are only a few who can replant children's amputated fingers." Huo Congjun couldn't help but raise his lips when he said this: "If you go, they have no reason to refuse."
For a 5-year-old child, 8 severed fingers were replanted, and four groups worked together. Such a large-scale operation is also atypical in Yunhua Hospital.
In atypical surgeries, department affiliation is less important.
Ling Ran's technology is strong enough, so he is qualified to participate.
At least, Huo Congjun thinks so, and he still has the ability to make it come true.