medical road high rise

Chapter 220 Permission to Resect
Chapter 2 Twenty
"The upper limbs are abducted and supinated at a right angle." Qin Feng and Zhao Qi began to adjust the position of the patient's arms.

After laying down the body position and disinfecting the drape, Qin Feng began to dissect the patient two centimeters below the elbow along the direction of the radial artery.

During the dissection, Qin Feng's incision was biased towards the inner side of the arm to prevent damage to the blood vessels on the outer side.

Layers of subcutaneous fat were separated by Qin Feng, gradually revealing the deep fascia, and Qin Feng's separation steps stopped at this step.

"Brother Qin, why did you stop?" Zhao Qi asked puzzled.

"There is the lateral cutaneous nerve of the forearm here, which is prone to damage. Let me observe it." Qin Feng explained.

Just as Zhao Qi was about to nod, he saw Qin Feng start to move.

"Look for the radial artery exposed underneath."

"??"

Zhao Qi was a little confused by Qin Feng's behavior. He was still observing the first second, and the blood vessels were directly exposed the next second. This speed is unmatched.

Maybe Qin Feng's observations are different from those of other doctors. The other doctors' observations may be analyzing the arm structure in their minds and how to dissect it to ensure that the nerves are not harmed.

But Qin Feng is different. Qin Feng directly observes how to make the operation faster.

Zhao Qi was still carefully pulling the radial artery pulled out from the red radial muscle, Qin Feng took the scalpel, hooked the little finger on the tissue and cut continuously to open up space for Zhao Qi.

"Brother Qin, why don't we slow down?" Zhao Qi looked terrified.

The front, middle, and back sections of the radial artery all have different characteristics, while Qin Feng separates the middle end, which is easy to separate after all.

It’s just that the radial artery itself has many accompanying blood vessels. If the knife is cut too hard or there is deviation, the accompanying blood vessels will rupture.

Zhao Qi is worried that the rupture of the accompanying blood vessels may lead to blood vessel congestion, and I will cause blood circulation. After all, Qin Feng only blocked the blood vessels of the radial artery. Once other blood vessels rupture, it will still cause bleeding.

It's just that Qin Feng doesn't seem to have these blood vessels in his eyes, but the speed in his hand is getting faster and faster.

Every time, he was able to avoid the accompanying blood vessels precisely, and this one-handed operation directly made Zhao Qi feel a little dazed.

"Keep pulling!" Qin Feng couldn't help scolding.

Only then did Zhao Qi come back to his senses, and continued to tug.

"Brother Qin, you performed the operation so quickly, aren't you afraid of the rupture of the blood vessel?" Zhao Qi couldn't help asking.

Qin Feng continued to move his hands and said: "This is to speed up the operation, so as to reduce the impact of the lack of blood flow in the hands."

"hiss!"

Zhao Qi couldn't help but be shocked by Qin Feng's audacity. It is because of how much heart and how sure he is of his surgical skills that he can have such a terrible idea.

UI?

As long as I operate too quickly, the blood loss will not catch up with the patient?
After thinking about it carefully, I found that what Qin Feng said was quite reasonable.

The patient is losing blood all the time on the operating bed, and the amount of blood loss is different every minute. If Qin Feng can complete the scheduled operation time in advance, he can indeed ensure that the blood flow will not be affected.

Qin Feng didn't care about what Zhao Qi was thinking, and directly freed the accompanying veins and fat tissue from the radial artery pulled out by Zhao Qi.

During transplantation, there must be no veins present.

Veins in any part may cause massive bleeding.

"Warm salt water gauze."

Lin Xue hurriedly went to prepare, and then Qin Feng took it and wrapped it around the radial artery tissue.

This is to avoid vasospasm in the radial artery, which would lead to ischemic visceral spasm. Even Qin Feng would find it very difficult, so try to avoid it if possible, so as to speed up the operation.

After wrapping up, Qin Feng continued to mobilize the radial artery. Before that, the middle section of the radial artery was the center, and then the upper and lower ends were mobilized.

The blood vessels at the upper end are relatively thick, while the lower segment has many perforators and is relatively small, so it is suitable for freeing later rather than first.

"Vascular clamp."

When Qin Feng stretched out his hand, he suddenly saw the patient's fingers move from the corner of his eye.

Everyone present except Lin Xue saw this scene.

"Ah? The anesthesia dose I gave him is absolutely impossible to wake up at this time." Lu Shan quickly explained.

The movement of the patient's limbs is a symptom of the patient's awakening. Waking up during the operation is undoubtedly a devastating blow to the ongoing operation.

At the same time, if this amount is recorded in the anesthesiologist's file, then the anesthesiologist will basically have no way out.

This is also the reason why anesthesiologists are willing to prolong the time during the operation, rather than deploying the right amount.

"It's okay." Qin Feng smiled and comforted, "How are the patient's indicators now?"

"It is now in a normal and stable state, and there has been no fluctuation."

Qin Feng nodded, lowered his head to study, and finally found the problem.

"Zhao Qi, when pulling, don't use too much strength, as it will easily involve nerves." Qin Feng said.

Zhao Qi lowered his head in shame. He was a little dazed just now, so he went a little harder.

Because the superficial branch of the radial nerve is on the radial side of the radial artery, once the superficial branch of the radial nerve is stretched too much, the superficial branch of the radial nerve will be mobilized. In severe cases, the nerve may be damaged, leading to postoperative complications such as numbness of the back of the hand and fingers.

After discovering the problem, Qin Feng felt relieved and continued with the operation.

During the operation, the patient's limbs moved, which had a psychological impact on the surgeon, no less than a fake corpse in the morgue.

With a slightly bad temper, I am afraid that Zhao Qi will be scolded bloody now.

"All right."

Qin Feng's final separation stopped at the radial recurrent artery, which cannot be touched.

Once the recurrent radial artery is gone, the blood flow throughout the operation will be affected.

"Prepare for the ALLen experiment."

This test is a way to check the blood supply to the hand and the anastomosis between the radial and ulnar arteries.

Qin Feng must ensure that there is no sign of ischemia in the blood supply area and that the collateral circulation is good before the radial artery can be completely removed.

"You go test the fist."

Zhao Qi walked to the left side of the patient, and kept clenching and loosening the patient's fist until the palm turned white.

Seeing this scene, the atmosphere can send love to the compression of the patient's ulnar artery, and the left hand is still compressing the radial artery, simulating the blood flow after the initial radial artery.

Zhao Qi continued to test the patient's fist, and the pale palm gradually returned to blood, which made Qin Feng smile.

After the radial artery was removed, the patient's palm still had normal blood supply.

It shows that there is a good collateral circulation between the radial artery and the ulnar artery. Even if the radial artery is cut off, it can also supply blood to the palm through the collateral circulation.

To be on the safe side, Qin Feng tried again, and after getting the same result, he ordered to cut the radial artery.

"There is no other abnormality in the Allen test, and the radial artery can be resected."

(End of this chapter)