medical simulator

Everyone in the operating room saw this scene, so they naturally knew that just now, Chen Kelong and Cai Dongfan were so frightened after seeing Tan Yuanwu's severed finger.

Curious what there is to see and what horrors there are.

But it is obviously not suitable to walk over at this moment.

Zhou Cheng didn't say much, just continued with his operation.

Before the operation started, he had already obtained the permission of the chief surgeon, which was given by Chen Kelong. Since he had already given it, there was no need for him to say too much.

If you haven’t encountered it, you can’t do it, there is no way.

Zhou Cheng was still not in a hurry to suture the blood vessels.Instead, the tendon is sutured first. The advantage of suturing the tendon first is that it can provide a soft tissue bed for the sutured blood vessel, which is convenient for suturing.

This sequence is the reverse of the long-term replantation of amputated fingers.

However, the operation method will never be static. Zhou Cheng has a perfect finger replantation. Although this is the first time he has used it, the rules and changes in it have long been familiarized by heart.

Moreover, in order to practice this skill, Zhou Chengfei put a lot of effort into training all the lower skills to the full level!

To suture the tendon, Zhou Cheng adopted the most commonly used modified Kessler suture method in clinical practice.

The tendons in the fingers are divided into extensor tendons on the dorsal side and flexor tendons on the palm side.

The flexor tendon group can be divided into superficial flexor tendon and deep flexor tendon, and the extensor tendon of the hand can be divided into central tendon and lateral tendon.

Therefore, the number of tendons that need to be sutured is not a lot.

However, the large number is not a difficult point, but the tendon must be sutured well and sutured just right.

Zhou Cheng's tendon suture is still perfect.

It is difficult for ordinary people to understand, and he spent his whole life pursuing it.

Suturing this kind of tendon is simply a small case.

Cai Dongfan and Chen Kelong re-entered, but still did not disturb Zhou Cheng. Instead, after seeing Zhou Cheng's suture, his scalp became numb again. Looking at the suture of the extensor tendon of the middle finger that Zhou Cheng had sutured, Almost couldn't find where the stump was.

The wrapping is so good that between the muscle breakpoints, it almost looks like it has been processed by high-tech PS tools.

However, this time, the two of them were slightly prepared, so they were not too scared.He sat down obediently, and then began to help Zhou Cheng, stabilizing the far and near ends of his fingers.

"Stitches!"

"Stitches!"

"Stitches!"

Every time a tendon was sutured, Zhou Cheng did not tie the knot first, and then cut it off to complete the next stitch.

It is every tendon and every suture. Although this will be more wasteful, it can save more time.Moreover, multiple tendons are knotted at the same time, which can better control the tightness of the knot, so that the length of the broken end of the suture and the tightness of the suture are not inconsistent.

Because after the length and tightness are different, the degree of force will be different, and the degree of force will be different, and there will be bumps.

Bumps, the more prone to scars!

Although scarring is definitely unavoidable, it can be reduced by a little bit.

These are not problems for Zhou Cheng.

Therefore, Zhou Cheng only started to tie the knots after suturing more than a dozen small tendons in a row!

"Crack!"

"Crack!"

The crisp thread-cutting sound sounded again.

At this moment, Mi Huan hurried in from the door, and asked as soon as he entered the door: "Chen Kelong, how is Qin Yuanwu doing?"

Then Mi Huan saw Chen Kelong and Cai Dongfan looking at them in a dumbfounded way. There was a man with his back on his back, wriggling his buttocks left and right, and the tail of the green surgical gown was constantly swinging. .

This man didn't reply to Mi Huan's words either.

Mi Huan frowned, and thought to himself, you two snake skins, is it because I'm about to retire, and you're starting to ignore me?

I haven't returned yet?Is the tea cold now?

After hearing the phone call from the department, he rushed down on purpose.

What's so great about watching someone else's surgery?

However, after Mi Huan shifted his position and saw what Zhou Cheng was operating, his feet stiffened on the spot, but he couldn't stabilize his forward posture in time, and staggered on the spot, obviously startled!

His eyes widened several times across the eyes, and he looked carefully at Zhou Cheng's hands, and he was quickly recalling the principle of replanting severed fingers in his mind!

① Debridement of the junction of the severed finger and the severed finger. ②Fixation of the phalanges with Kirschner wires. ③The tendon is sutured with cotton thread or nylon thread. ④Sequentially anastomose the finger artery, finger vein, and finger nerve. ⑤ Z-shaped suture the skin, and finally bandaged and fixed!

If I'm not mistaken, the operation that has been done now is to suture the tendon.

The tendon can be sutured, shouldn't it be slightly uneven?

The level of this stitching?Mi Huan looked dazed and bewildered.

This forced?

Why is it so flat?

Mi Huan is 58 years old this year. He has eaten and seen many times, but he has never seen someone who can suture the tendon so smoothly.

Chapter 151 Zhou Liyi!

How did it get so neatly stitched?Shouldn't the normal force be uneven...

Mi Huan's heart was agitated, and while watching Zhou Cheng continue to operate, he asked Chen Kelong: "Kelong, who is this teacher?"

Looking at Zhou Cheng's profile, most of it was covered by the mask, but he didn't see Zhou Cheng's crow's feet, which made Mi Huan confirm that Zhou Cheng's age should not be very old.

He thought Zhou Cheng was some kind of professor invited by Chen Kelong.

Chen Kelong stretched out one hand at this moment, staring at Zhou Cheng's operation of suturing the tendon.

It seems to mean, don't bother me.

But he also closed his mouth and looked in the direction of Chen Kelong's gaze.

I saw that Zhou Cheng's silky knot at the moment was like wearing a trouser belt, neither loose nor tight.

He was able to grasp the degree just right so that the tendon did not retract, but there was a certain tension, and it was able to tightly fit the broken ends of the tendon together.

If the operation of surgery is compared to the kung fu in martial arts, it has at least reached the level of proficiency!

After sewing all the threads one by one, Chen Kelong, the 'right-hand man', picked up the threads and cut off the thread ends one by one.

Then, the same flattened tendon as the one sutured before appeared in front of everyone.

This time, Mi Huan was finally able to see the ruptured tendon in person, and he performed a scene of recovery in front of his eyes, as if the couple had quarreled and reconciled, but there was no gap at all. , Completely reunited!

It's easy to break, a child can break it with a knife, but it can only be completely restored, which can only appear in theory.

Zhou Cheng glanced at the thread cutter and said, "The thread knot was cut a little too long! This is not conducive to postoperative recovery, so I will cut it shorter next time. This is a thread knot of the finger tendon, so it should not be so long."

The corners of Chen Kelong's mouth trembled slightly, and he had the urge to beat Zhou Cheng to death on the spot.

This guy seems to have a million insults.

Damn, I even made a mistake when I cut the thread.

And Cai Dongfan and Mi Huan felt a little funny when they heard these words.

Cai Dongfan hurriedly slapped Zhou Cheng's hand and said, "Speak less and do more."

At this time, Chen Kelong replied to Mi Huan: "Director Mi, this is Cai Dongfan from the Eighth Hospital, Director Cai."

Then he stretched out his hand to Cai Dongfan, but Mi Huan nodded in Zhou Cheng's direction without even thinking about it: "Oh, I said who it was, it turned out to be Cai."

Then I saw that Chen Kelong's hand was pointing at the 'vegetable chicken' sitting next to him, and the person he greeted was not Cai Dongfan as Chen Kelong said.

It was a bit embarrassing for a while.

"This is Zhou Cheng, Director Cai's student." Chen Kelong hurriedly helped Mi Huan relieve the embarrassment.

Mi Huan originally planned to call out Professor Zhou, but he only uttered one word, so he couldn't yell out.

"week."

He glanced across at Chen Kelong, his eyes scratched at Chen Kelong's body like steel knives, as if he wanted to kill Mi Huan.

"Doctor Zhou." Mi Huan pondered for a while, then said to Zhou Cheng.

"This is the director of our orthopedics department, Director Mi Huan." Chen Kelong introduced Mi Huan's identity to Zhou Cheng.

Zhou Cheng paused for a while: "Hello, Teacher Mi."

As he spoke, he was about to step aside, but this made Mi Huan say repeatedly: "Doctor Zhou, you continue, you continue."

It seemed that Zhou Cheng was afraid that he would say, Mr. Mi, come here.

The skill of the surgeon is all in hand, and anyone with a discerning eye can tell it at a glance!

It doesn't need to be too mysterious to make ordinary operations very smooth.

The replantation of severed fingers belongs to the specialty of hand surgery. Before Shaxian No. [-] Hospital separated, he had contacted and even consulted some experts in hand surgery. More experience with salt is sure.

Zhou Cheng's tendon suturing today is absolutely no worse than any professor's tendon suturing he has seen.

There was even an absurd illusion that Zhou Cheng stitched better.

Such a good tendon suture is not only beautiful, but more like a work of art, which cannot be stained. If the rest of the blood vessels and nerves are sutured by oneself, it is simply too unworthy of the vascular bed sutured by Zhou Cheng now.

Tendons are just vascular beds.

The top priority of severed finger replantation.

The recovery of broken bones and the suture of tendons can be done by ordinary orthopedic surgeons. Whether it is good or not is another matter, but whether they can survive or not depends on the blood supply after surgery, and the state of blood supply after surgery is the most important thing. The most important thing is how well the blood vessels are sutured.

Survival of the fingers is the basis of sports, if they cannot survive, let’s not talk about sports.

And even if the blood supply is sutured, it depends on how well the nerve is sutured, otherwise, the finger that lost the innervation is still just a decoration!

No matter how well Zhou Cheng sewed up the tendons, and no matter how quickly the broken bones healed, if the nerves and blood vessels were not properly sewed up, it would be a waste of water in a well, beautiful but useless.

Mi Huan didn't want Zhou Cheng to say the following because of his status, "Chen Kelong, you should learn from Director Cai and Dr. Zhou. I'm going to wash my hands first."

Chen Kelong nodded and looked at Zhou Cheng with a solemn expression. Zhou Cheng's hand skills definitely deserved to be called a teacher, but his age and status were a little bit out of sync.

Cai Dongfan was in a very good mood at the moment, looked at Zhou Cheng and said, "Xiao Zhou, are you tired, do you want to take it easy?"

All surgeons know that surgery is not heavy physical work, but the fatigue during the surgical operation is more tiring than heavy physical work.

Because it requires precision, high concentration, and trembling.

For example, if you want to cut the rice in half with scissors, it is much more tiring than if you pick rice tens of catties larger.

Zhou Cheng took a deep breath and said, "Teacher Cai, Director Chen, let's continue."

Then he continued to bury his head and began to get out the trimmed blood vessel stump.

Regardless of whether it is the middle finger or the ring finger, the blood vessels and nerves are all on the opposite side of the finger, the proper arteriovenous and digital proper nerves!

For limb replantation, the optimal number of arteries and veins is 2:1.

However, the arteries and veins on the fingers are so small.At this time, I will not talk about the branches of the proper arteries.

Just the second after Chen Kelong stopped to watch Zhou Cheng's operation, his face turned pale again with fright.

Because he suddenly saw that Zhou Cheng just used two tweezers specially used for microsurgery to pick up a little, and a blood vessel on the ulnar side of the middle finger near the proximal interphalangeal joint was surrounded by it like a white and fat rhizome. Cheng pulled it out!

It seems to say, don't run.

The blood vessel at one end was thus found.

This kung fu?

I don't understand.

Then Zhou Cheng picked it up again, and another fat blood vessel was picked out from near the interphalangeal joint at the far end of the middle finger. After pulling it together for a while, Zhou Cheng said, "Teacher Cai, pull it out for me."

Chen Kelong immediately said: "Let me pull it, Director Cai, help Xiao Zhou to sew up, I'll take a look at it."

Under normal circumstances, the reason why the blood vessels are sutured first is not only the need for blood supply, but also the most uncomfortable problem in suturing the blood vessels sutured by severed fingers is to restore the tendons and broken bones first, and then recover the muscles that have been retracted into the muscles. blood vessels and nerves.

It's not easy to pull it in advance. Most people would tie it up with sutures in advance, which is easier to find, but Zhou Cheng didn't do this step.

Chen Kelong originally thought that this was one of the failures of this operation, and Zhou Cheng was greedy for success, but unexpectedly, Zhou Cheng already had a plan in his heart, and he could convince others with his strength.

Just take it out.