medical road high rise

Chapter 196 Amputation of Toes ([-])

Chapter 196 Amputation of the toe ([-])

This time, Qin Feng chose the second and fourth toes of the patient's right foot. Qin Feng also had his own considerations in choosing these two.

Relatively speaking, the big toe and the second toe are relatively flexible, but the big toe is not for sale on the sole of the foot, and its function on the sole of the foot is far more than that of the palm.

At the same time, the operation is still a "beautiful" operation. The toes are different from the fingers. The toes are inside the shoes, but the fingers are exposed outside.

The big toe is relatively large. Some people's big toe is bigger than the thumb of the hand, like a thumb plus.

Second and fourth, another point is that each of the two toes has two arteries from the deep arch of the foot, extending from the root to the toes, playing the main role of blood supply, forming a small blood supply circulation.

The two have the same effect as the fingers, and at the same time, in terms of structure, the blood vessels and nerve distribution of the two are consistent.

Qin Feng picked up the surgeon, and after Director Zhang had finished disinfecting his feet, he went straight up with a knife.

On the side of the dorsum of the foot close to the calf, Qin Feng cut open the superficial skin, and then clamped the punctured posterior tibial artery with blood vessel forceps to block it.

This artery is a main artery that supplies blood to the soles of the feet. Between each toe, blood from many arteries including the soles of the feet flows through here.

Qin Feng had to clamp this area to suppress bleeding and avoid causing massive bleeding when cutting off the toes.

After blocking the posterior tibial artery, Qin Feng carefully divided it along the joints connecting the toes and soles of the feet.

When it was about to be severed, Qin Feng did not cut off the internal blood vessels directly, but marked the plantar artery of the toes with a ribbon, and the ribbon used for marking corresponded to the marked blood vessel in the palm of the hand.

After marking, Qin Feng directly and quickly performed the amputation. After quickly removing the two toes, Qin Feng quickly perfused and flushed with the prepared heparin saline, and shortened and fixed the bones of the toes at the same time. After transplantation, the bone becomes loose and prone to fractures.

After this step of amputation surgery, the patient's physical condition, limb blood supply and various laboratory indicators were all normal. Qin Feng also breathed a sigh of relief.

"Go to the last step, transplant." Qin Feng said in a hoarse voice.

Director Zhang and other medical staff suddenly became serious, and each of them cheered up.

Surgery in the early morning is a very difficult time for medical staff and doctors, and the human body is the most sleepy at this point in time.

Even Qin Feng felt tired, let alone other people.

Doctors are human beings, not gods.

Qin Feng bit the tip of his tongue, and the tingling sensation was sent to the brain center through the nerves, and Qin Feng became sober in an instant.

The next step is more critical than the first two.

This step is also the key to this operation. The first two steps can be performed by other hand surgeons. It is just amputation and cleaning of the severed limb. However, Qin Feng distinguished each blood vessel and nerve to make the operation more convenient. .

The real difficulty lies in connecting the toes with different blood vessels, nerves, and bone structures to the gap in the palm. At this step, everyone looks at Qin Feng.

Qin Feng took a deep breath. "Prepare temporary endoluminal shunt."

This kind of shunt tube is to prevent blood from flowing into the cavity of the finger due to the rupture of the blood vessel during the finger joint process, resulting in blood accumulation.

"Intramuscular injection of 0.3mg atropine and 0.1g phenobarbital sodium." Qin Feng said.

Atropine can relieve smooth muscle spasm. Microinjection can relieve vasospasm, improve blood microcirculation, and inhibit gland secretion function.

Moreover, using atropine can relieve the suppression of the nerves on the heart to a certain extent. The heart beats faster and the respiratory center is excited to relieve respiratory depression and prevent the symptoms of suffocation. At the same time, the heart beats faster and the blood flow speeds up. The patient's body function is temporary. of enhancement.

The enhanced physical function of the patient is also a great help for receiving the transplanted toe.

Phenobarbital sodium mainly acts as a sedative to prevent patients from experiencing abnormal movements.

After the drug injection, Qin Feng entered the operation state.

Place the amputated toe on the broken surface of the palm, anastomose the blood vessels as much as possible, and at the same time put the toe down, and temporarily fix it with a Kirschner wire.

After fixation, what Qin Feng has to do is to reconstruct blood vessels under microscopic surgery. The requirements for blood vessel reconstruction are very high, and at least one-third of the anastomosis must be achieved. Otherwise, even if the transplanted toe can survive, the patient's palm will Movement will also be greatly affected.

Qin Feng's mind turned for a while, and he still chose to rebuild the artery first.

In fact, compared with arteries, it is veins that need to be anastomosed, and veins can promote the recovery of limbs.

But taking the lead in rebuilding the artery will help restore the blood supply and circulation as soon as possible, and make the venous anastomosis more convenient.

However, there were too many blood vessels, and it would be difficult for Qin Feng alone to perform the anastomosis.

This is a microsurgery, not an ordinary operation. In an ordinary operation, Qin Feng can fix it with one hand and suture it with the other.

But the microscope is not good, Qin Feng has to constantly adjust the position of the lens, and at the same time control the vascular forceps and needle holders, and one person must cooperate to fix them.

"Director Zhang, fix it for me." Qin Feng said.

"Which one matches first?" Director Zhang was also ready to help at any time, and arrived at his place the moment Qin Feng spoke.

Qin Fengdao: "First connect the proper palmar artery and the plantar toe plantar artery, and then try to connect the deep plantar arch structure with the deep palmar arch and the superficial palmar arch."

Director Zhang frowned. Although Qin Feng said it so lightly, it is as difficult as climbing to the sky if you really want to do it well.

At this time, it was not the time to attack Qin Feng. Director Zhang could only follow Qin Feng's words.

With the help of Director Zhang, Qin Feng does not have to worry that the tremor will cause the blood vessels to escape the field of view, and he will need to waste time on debugging before performing follow-up suturing.

Listening to Qin Feng's command, the blood vessels were sutured one by one in Qin Feng's hands. Even some parts made Director Zhang feel uncomfortable.

For example, the blood vessels in the superficial fascia are very elastic, so it is not easy to suture and reconstruct, and even perforation is even more difficult.

But Qin Feng didn't even look carefully and just passed through.

Yes, it's the kind that goes through with a needle.

Even the subcutaneous fat pad divided by fiber bundles was easily pulled together by Qin Feng with sutures.

In less than an hour, Qin Feng had connected the subcutaneous blood vessels, lymphatic vessels, etc. together.

After sewing the last marked artery, Qin Feng breathed a sigh of relief, but Director Zhang gave a reminder.

"There is bleeding from the wound."

Qin Feng looked over, but he was relieved and said with a smile: "The bleeding on the wound surface proves that the inside of the artery is intact, and the vein anastomosis can be done directly."

After listening to this, Director Zhang recalled it in his mind, and it seemed that it was exactly what Qin Feng said. He was still worried about the bleeding caused by blood vessel sutures.

(End of this chapter)