Doctor's Life Simulator

Chapter 71 Li Lian'an's Finale Surgery
According to the monitoring of Wu Youtu and You Daren, the MAP of each branch of the external carotid artery is close to each other, the MAP of the distal end of the artery decreases by 17.81% after occlusion, and the ratio of stump arterial pressure can be maintained above 70%, so it proves that retrograde The blood supply mode nourishes the free skin flap is feasible!

Looking at the data monitored by Qin Lang and others in the operating room, several directors in the observation room were also very excited.

Shen Jiachen clenched his fist even more tightly:

"In antihypertensive anesthesia, the internationally generally accepted reduction in blood pressure is 30%. A reduction in blood pressure exceeding 30% may lead to organ blood perfusion decompensation, while the retrograde mode is less than 20%, which is equivalent to human night sleep. Physiological blood pressure reduction in the state. It is enough to show that the use of external carotid artery branch vessels as retrograde blood supply and recipient areas is feasible and safe."

At the same time, Shen Jiachen also gave prestige to his subordinate doctor who was still in the First Affiliated Hospital of Zijingang University. Soon, he received the data collected by the subordinate doctor:
"Everyone, there is another piece of good news. I asked my colleagues to count the arterial pressure ratio of the stump after the descending branch of the lateral circumflex femoral artery of the lower extremity was occluded in our hospital. In defect repair and reconstruction, it is more reliable to nourish the free skin flap with the retrograde blood supply mode than the extremity blood vessels. This is a remarkable result!"

After hearing Shen Jiachen's specific data analysis, several directors in the observation room got a better understanding of the excellence of this technique.

"Director Wei, after I go back, I must report this matter to our Director Meng, and demonstrate this brand new retrograde blood supply mode at this Asia-Pacific International Burn and Plastic Surgery Forum!"

The eyes of Dean Hang and Dean Sun on the side are brightened. If this operation can be selected into the Asia-Pacific International Burn and Plastic Surgery Forum, it will have a decisive effect on the influence of the city's first hospital.

"Director Shen, then I will trouble you to recommend it to Director Meng."

In this matter of improving the overall strength and reputation of the city's first hospital, Dean Sun and Dean Hang's goals are still the same. Internal competition belongs to internal competition, but external interests are always the same.

"No, it's my pleasure."

Shen Jiachen said seriously to the two directors, and he was very excited. This new retrograde blood supply mode is also very inspiring to him. Obviously, after returning to the First Hospital of the Affiliated University of Bauhinia Hong Kong, he will also start to carry out similar directions. research in order to benefit more patients.

In the operating room, Qin Lang also quickly completed this operation. Speaking of it, the difficulty of this operation itself is not great, even lower than the conventional operation, but because of this, it reflects The clinical significance of this modified procedure.

However, this time the competition is not over yet.

After the directors communicated with each other, they continued to calm down and watch the remaining two operations, which were also demonstrations of the improved surgical techniques in hand surgery.

After viewing Qin Lang's two improved procedures, the directors were also full of interest in the remaining core procedures of hand surgery.

On the screen, Li Lian'an has already started the third operation, and this time, he thinks it is the trump card: free nail flap transplantation to repair the skin defect of the thumb.

Seeing that Li Lian'an was starting to prepare, Director Tian Bo calmed down and began to introduce this improved technique that he had carefully prepared, to save some face.

".The thumb is an important finger in the hand function, and it is also an essential finger for grasping objects. It accounts for about 50% of the hand function. If the skin, soft tissue and part of the bone of the thumb are damaged due to trauma or disease, the hand's The function will be greatly affected, and the traditional treatment method is flap repair.”

After introducing the brand-new technique he improved, Tian Bo's whole demeanor changed, full of confidence and pride:

"Everyone knows that the skin of the hands is special, but there are no nails, which will cause disadvantages such as non-wearability, easy bruising, poor feeling, and poor appearance. Therefore, this time, our hand surgery team proposed the use of nail flap transplantation to repair Thumb skin defect."

"The big toe is the tissue closest to the thumb in the human body. Free transplantation to repair the thumb defect of the hand can not only achieve the purpose of covering the wound, but also make up for the bone defect. At the same time, the tissue is similar, the finger pulp is wear-resistant, and the nails can also grow. The appearance Similar. In view of this, our department has conducted clinical trials on 13 patients with thumb skin defects treated in the past three years, and this time Li Lian'an showed the 14th case."

When Tian Bo introduced him, he also announced his admission standards. It has to be said that his preparations were more detailed and comprehensive than those of Wei Guoqiang.

It's just a pity that I met the unreasonable Qin Lang.

"According to the grading method of simple thumb and finger defects in "Hand Repair and Reconstruction": 6 cases of I-degree defect, 3 cases of II-degree defect, and 4 cases of III-degree defect, and this time Li Lian'an showed a case of III-degree defect .”

During Director Tian Bo's meticulous explanation, Li Lian'an also started his presentation in the operating room.

Putting aside Qin Lang's performance, Tian Bo's academic ability has been fully demonstrated in this introduction process, and his characteristics of meticulously leading the overall situation can be seen at a glance.

In the observation room, the rest of the directors were also emotional. Director Tian Bo was as powerful as ever, and no one in the room dared to underestimate him.

Wei Guoqiang also heaved a sigh of relief, this time it was thanks to Qin Lang's efforts to turn the tide, otherwise with his preparation, this time he would have lost miserably.

Moreover, Wei Guoqiang had to admire Tian Bo's exquisite and comprehensive surgical design.

In the operating room, Li Lian'an and his assistants had already given the patient brachial plexus combined with epidural anesthesia, and began the operation under the control of a tourniquet.

The first is the debridement of the harvest, and the trimming of the bone stump.

Seeing Li Lian'an's operations, all the directors nodded again and again, and he was still as stable as ever.

Of course, it is still a bit worse than Qin Lang's debridement just now, but it is commendable that such a young doctor can do this.

Immediately afterwards, Li Lian'an began to freely mark the proper nerve in the recipient area.

Li Lian'an used a very conventional longitudinal arc-shaped incision in the patient's hand snuff pocket, freed and marked the deep branch of the radial artery.

Seeing Li Lian'an's well-regulated operations, several directors have begun to lose interest. After all, Qin Langzhuyu is in front.

Even Director Tian Bo himself frowned slightly, looking at Li Lian'an's bland operation, feeling a little sad.

Next, for the dorsal side of the patient's finger and metacarpal joint, the free dorsal vein is cut and marked for use. The whole process is ordinary.

In the observation room, Shen Jiachen yawned quietly.

In the next step, Li Lian'an used the thumb of the healthy side as a standard to measure the area of ​​the tissue defect and the length of the bone defect.

According to the area and shape of the thumb defect, the flap was designed on the fibular side of the ipsilateral foot and toe. During the design process, the defect was obviously exceeded by about 1cm!

As usual, these directors didn't think there was anything wrong, but when they thought about the precise cutting before Qin Lang, Li Lian'an's conventional and conservative zoom-in operation seemed a bit inferior.

Director Qian Mubai secretly squinted his eyes, took out a piece of candy from his pocket and swallowed it.

Obviously, these directors are very tacit preparations, take advantage of Li Lian'an's operation, take a break, after all, Qin Lang's third operation is about to start.

PS: Thank you for your votes and support, and regain the top ten.Thanks for the reward of 100 coins for dyeing all white, 500 coins for YY, and 100 coins for the rain in the northeast, thank you everyone.Due to working overtime today, it's a bit late, so hurry up and code Chapter 2.

(End of this chapter)