medical road high rise

Chapter 195 Amputation of Toes ([-])

Chapter 195 Amputation of the toes ([-])

Qin Feng also tried it in the training room and learned a lot of lessons.

One of the points is that the toes are amputated first, causing the temperature of the toes to be too low, which induces complications such as vasospasm. This problem is useless even if it is stored in an incubator.

Therefore, Qin Feng chose to amputate his finger first.

"Give the patient general anesthesia." Qin Feng said after going through the operation process in his mind.

Since the patient's physical condition is good and there is no major problem, Qin Feng is also very relieved of general anesthesia.

Generally, when encountering this kind of patient, the patient will suffer from coma or hemorrhagic shock. Fortunately, this person is strong-willed, and at the same time, the hand surgery department of the Second Hospital completed the hemostasis work without procrastination, keeping the patient's condition stable.

What happens next depends on Qin Feng's operation.

Qin Feng looked at the instrument tray next to the operating table. Although this operation is said to be a replantation of a severed limb, it is different from a normal transplant operating room because it needs to regenerate fingers. Surgical approach.

In addition to two sets of standard surgical microscopic instruments (two sets are usually prepared to prevent contamination), there are four conventional debridement kits, two tissue curved scissors and two straight scissors, toothless short forceps and Ant's pliers etc.

Lin Xue had already installed the operating microscope for Qin Feng, and the patient's anesthesia had begun to take effect.

"Open two venous channels, replenish fluids in time, and transfuse blood throughout the operation. If the plasma is not enough, you can replace it with plasma or whole blood." Qin Feng arranged, "By the way, we also need to install a urinary catheter."

"Urinary catheter?" Director Zhang looked at Qin Feng with some puzzlement.

Qin Feng nodded and said: "The placement of the urinary catheter is to observe the patient's physical changes. Regenerating and transplanting fingers is not a minor operation, and I can't guarantee that the operation can be completed quickly, so the patient's physical condition needs to be observed during the operation, and urine is the the best choice."

"During the operation, we need to inject a variable amount of drugs to the patient, and at the same time judge the patient's absorption of the drug and physical function. Observing urine is the best choice."

Director Zhang turned his head and inserted the urinary catheter into the bladder. When orange urine flowed out, Qin Feng also started the operation.

The first step is debridement and disinfection.

If it's just an amputation operation, after debridement and disinfection, the excision can be performed directly, and then a good drug bandage can be applied.

However, this time it is the regenerated and transplanted finger. Qin Feng must be more careful and careful during the debridement and disinfection process. In addition to treating the section well, he must also ensure that the main nerves and blood vessels are fully exposed.

Otherwise, even nerves and blood vessels cannot be found, so what about transplantation?
Qin Feng put the patient's palm section down and carefully washed it with soapy water and hydrogen peroxide. After the surface was debrided and disinfected, Qin Feng used small tweezers and micro instruments to start debridement inside the section.

Because of the damaged severed finger, there will be rotten tissue around the severed finger, and at the same time, Qin Feng has to use some of the available blood vessels. Compared with the regenerated blood vessels, the original blood vessels at the severed finger must be stronger than the regenerated blood vessels.

Qin Feng stretched out his hand, and Lin Xue patted the tissue scissors on Qin Feng's hand. After taking the tissue scissors, Qin Feng slowly cut open the skin of the severed finger with a steady movement.

As the skin tissue was cut open, the tiny blood vessels that had ruptured within the severed finger were revealed.

Although most of the blood vessels have been broken, there are still a small number of them that are well preserved and can be connected. Qin Feng marked the intact blood vessels one by one.

Qin Feng glanced at the patient's superficial palmar arch and deep palmar arch. There is an anastomosis of axillary artery and brachial artery in these two places. Because the thumb and index finger are damaged, the blood vessels need to be clamped. Qin Feng's task is to deal with this The major arteries were ligated.

Taking these two palm bows as the center, Qin Feng also has his own considerations, because there are abundant arterial communication branches between the shallow palm bow and the deep palm bow, mainly to protect the palm during various movements. No ischemia.

Therefore, when resecting the remaining fingers, care must be taken not to damage the superficial and deep palmar arches, otherwise the recovery of the palm's motor ability will be greatly hindered later.

Then, Qin Feng marked the main palm muscle groups such as the abductor pollicis brevis, flexor pollicis brevis, oppositus palmaris and flexor pollicis longus tendon.

These muscle groups are the muscles that drive the thumb and index finger to complete the bending, stretching and other actions. Therefore, to do transplantation, these parts must be marked, and then the muscles on the toes are marked according to the parts of the fingers. palm needed.

Qin Feng looked into the microscope, removed the embolized blood vessels and damaged nerves, and repaired some less damaged arteries and veins as much as possible.

What Qin Feng is doing now is to make more blood vessels in the severed limbs work. The more blood vessels, the better the recovery ability of the transplanted and regenerated fingers. At the same time, the recovered fingers can do more things, just like normal fingers. .

"Needle pliers."

Qin Feng picked out the bad tissue, and all that was left was to suture all the blood vessels that could be saved.

As time passed bit by bit, there were no other sounds during the operation except for the possible sound of instruments colliding on Qin Feng's side.

This kind of microsurgery is different from other surgical operations. A careless microsurgery may ruin the whole operation.

In addition, this operation is of great significance, and it is even more impossible for anyone to chat at this time.

When he was a child, Qin Feng successfully peeled off the thumb and index finger from the patient's palm, and the phalanx was also severed.

Seeing this scene, Director Zhang's hanging heart slowly fell.

At least, the operation is half done.

"Director Zhang, is it okay to give these two fingers to you?" Qin Feng asked.

Director Zhang showed a displeased expression, "What did you say? I have been in this industry for more than ten years anyway, and I can't touch it with two fingers, so I might as well take off this white coat."

"Then I'm going to amputate the toes." Qin Feng took a look at Director Zhang's operation, then confidently handed the finger to Director Zhang, moved the finger to the patient's toes.

Compared with the previous step, interception is the simplest.

Because the vascular tissue and structure of the patient's toes are intact, while the tissue and structure of the fingers are damaged, they need to be treated step by step.

At the same time, the blood vessels in the feet are tougher and more elastic than those in the fingers due to long-term exercise and compression, and the nerve response here is stronger than that in the fingers.

The feet of the human body are the farthest place from the heart and the brain, and the brain cannot issue instructions immediately, so neurons need to process blood circulation through the movements of the feet to allow the blood vessels to contract.

This is why Qin Feng proposed that toes can replace fingers.

(End of this chapter)