I don’t know what time it is in the middle of the night.
Duty room, banging on the door.
"Who is going to stop letting people sleep?" Zhang Lin opened the door and shouted, his eyes were sleepy and he wanted to hit people.
There is a switch at the nurse's station. When pressed, the bell in the doctor's duty room will ring and the conversation can be broadcast. Zhang Lin thought that the intern nurse did not understand, so he came and knocked on the door.
"Director Tian?" This is a mistake.
Director Tian was putting on his white coat, with a look of anger, no, murderous look on his face: "Have you done the surgery?"
Zhang Lin rubbed his sleepy eyes: ‘Yes!’
"You are so brave and irresponsible, is there such a thing?" If it weren't for years of higher education, Director Tian would be scolding her now.
Zhang Lin was so scared. When he was in the dressing room after the operation, he wanted to call Director Tian to report, but his phone ran out of battery. He was afraid that it would automatically shut down, so he thought about going back to the ward to recharge before calling. However, he got sleepy and forgot about Director Tian.
It’s over.
After this fierce criticism, I remembered: Director Tian should have done this surgery because it was stuck on the road due to traffic jam.
What time was it? The operation was completed, and he came here and knocked on the door angrily. Zhang Lin was dissatisfied, but he couldn't show it on his face.
After all, it is common for lower-level doctors to be scolded by superior doctors.
After being scolded by Director Tian, Zhang Lin immediately woke up and picked up Yang Ping, who was still sleeping.
Director Tian put on his white coat and went to check on the patient's severed finger's blood flow. Zhang Lin and Yang Ping followed behind, saying nothing and not daring to fart.
In order to wake up, Zhang Lin quickly took out a box of Fengyou essence and applied it to his temples.
The two figures looked like elementary school students who made mistakes, following behind the dean.
It turned out that as soon as Director Tian arrived at the department, he went straight to the operating room. When he asked the nurse, he said that the operation had been completed and the patient had been back for an hour.
Returning to the department, the nurse said that Yang Ping and Zhang Lin were sleeping.
He counted with his fingers and found that it had been more than two hours since he received the call, and the patient had been back for an hour, which meant more than an hour of operation time.
In an hour, based on the skills of these two bastards, wouldn't they just do a larger debridement and suturing? Could it be that these two bastards, regardless of whether he has arrived or not, can't wait any longer, even the blood vessels
The nerves are not connected to anything, Kirschner wires fix the broken finger fracture, and the epithelium is sutured directly?
Is it so ridiculous? If so, this will be a medical accident!
This is fake surgery.
Tianyuan's footsteps are getting faster and faster, the more he thinks about it, the angrier he becomes, and blood rushes to the top of his head.
I don't care about disturbing the patient's rest. It's still a few hours after the injury. If there is still hope to go back to the operating table, wait until tomorrow morning. After a long time, the finger will be necrotic.
One can almost imagine that the patient’s sewn-on severed finger is pale, shriveled, cold, and has no blood supply!
There was a snap, the sound of a switch, and the lights in the ward came on.
The analgesia was done well and the patients all fell asleep.
When the light was suddenly turned on and the doctor came to the bedside, the patient and his companion immediately woke up and squinted their eyes to avoid the stimulation of the bright light, not knowing what was going on.
"Ward round, check the blood flow of the fingers!" Zhang Lin stood tremblingly beside the bed, explaining to the patient, and then turned on the small flashlight he carried with him.
Tianyuan squeezed Zhang Lin away, grabbed the flashlight, and took a photo.
The end of the severed finger was exposed, full and ruddy. Tianyuan gently reached out and touched it, and it was warm! Then he squeezed it gently. The finger pulp was full and elastic, and the capillary reflux test of the nail was normal.
How is this possible? It’s unreasonable.
"Syringe needle!"
At this time, the nurse had already pushed a dressing cart over, which contained dressing packs, cotton swabs, amriodine disinfectant, syringes, etc.
The nurse handed over two cotton swabs dipped in amriodine, Tianyuan sterilized them twice, and handed over the syringe with the needle. Tianyuan carefully inserted three needles at different locations on the fingertips, just under the skin.
Bright red blood slowly emerged, starting with a little, then slowly expanding, and finally flowing to one side. Tianyuan turned to look at Yang Ping, then at Zhang Lin.
"The blood supply is very good! Sorry to bother you, we have to check the blood supply every hour." Tian Yuan explained to the patient.
The patient and his family members hurriedly said: "It's okay, thank you doctor for your hard work." They felt a little shocked.
Everyone returned to the doctor's office and sat down. The atmosphere was quite tense.
Tianyuan's thoughts were suddenly blocked. What happened? Did they anastomose the blood vessels? Impossible. It only lasted an hour, with two sessions separated. It was normal to do it for two or three hours by myself, and the condition of the equipment was good. This
It's impossible for two boys to spend an hour. I don't know what the problem is? Or the time is wrong.
"What time does the patient arrive at the emergency department? What time does he enter the operating room? What time does the operation start? When does the operation end?" Tian Yuan asked a series of questions.
"I arrived at the emergency department around ten o'clock, arrived at the operating room at ten-thirty to start debridement, officially started kissing blood vessels at eleven-thirty, and the operation ended at about twelve o'clock." Zhang Lin remembers it clearly, although the specific time is
I can’t remember clearly, but I remember the approximate time.
The nurse was also stunned by Tianyuan's expression, thinking that something big had happened. This nurse was more flexible and immediately brought the medical record folder over. Tianyuan took the medical record folder.
"It's okay, you go and do your work. Let's sit here for a while." Tian Yuan said to the nurse gently.
He carefully opened the medical records and found the anesthesia sheet and surgical care record sheet. He pressed his finger on the time on them and looked carefully. There was not much difference with what Zhang Lin said.
The actual operation only lasted half an hour, who was trying to coax him?
"The blood vessels are really anastomosed?" Tian Yuan asked.
"Two arteries, four veins! Two fractures, each fracture is anastomotic like this." Yang Ping said seriously.
Tian Yuan adjusted his glasses: "The blood supply is good now, but the operation only took more than half an hour. Why is it so fast? Is it a complete disconnection?"
Tianyuan then realized that it might not be a real severed finger at all. There are still tissue connections. The blood vessels on one side are good. Whether the blood vessels are sutured or not during the operation, it will not affect survival. This is diagnosed as an open fracture, which is different from a severed finger.
They are two different things.
But--but--I have seen Zhang Linfa's picture, and it is clearly broken, and it is still two sections.
"Complete disconnection, two disconnection planes!" Zhang Lin relaxed his tense nerves, turned on his phone, and called up the picture. He understood that Tian Yuan suspected that he and Yang Ping did not anastomose blood vessels, but only performed simple sutures.
In this case, there is no need to be nervous. I saw the entire operation process. Not only were the blood vessels anastomotic, but the quality was also very good. I was so scared that I almost had a myocardial infarction.
"Director Tian, the video was recorded during the operation. Why don't you watch the video?" Yang Ping said.
Zhang Lin also remembered, wasn't there a video? He was so nervous just now that his head was confused: "Yes, it's true, there is a video. I copied it and it's on our office computer."
Look at the video, this is a way, Tian Yuan nodded.
Everyone gathered around the computer, and Zhang Lin pulled up the video. As the video played, Tian Yuan turned to look at Yang Ping suspiciously from time to time - is this guy doing the surgery in this video?
There is not a trace of jitter in the instrument under the microscope, and the movements are extremely skillful, smooth, steady and brisk, without any unnecessary movements. Every movement is done in one go. Whether it is blood vessels, nerves or tendons, the quality of the anastomosis is not generally good, even if there is
Talent, there are hundreds of thousands of surgeries that cannot match this skill, even the final skin suturing is perfect.
Operating under a microscope requires special training and a certain amount of talent. The hands must be well balanced and must not shake, because a little shaking will be magnified under the microscope and seriously affect the operation.
The requirements for anastomosis of blood vessels are extremely high. The tissue outside the broken end of the blood vessel, including the adventitia, must be cleaned. Otherwise, during the anastomosis, a little bit may be brought into the lumen of the blood vessel, which will cause thrombus and block the blood vessel. The blood vessel apposition must be precise and cannot be
If there is any misalignment, otherwise the blood vessels will be narrowed or uneven, resulting in abnormal blood flow, slowing down the flow rate or forming vortices, which may also easily cause thrombus and block the blood vessels.
Therefore, the anastomosis of small blood vessels requires the highest suturing technology in surgical operations.
A surgeon has to practice anastomosing countless mouse tails or rabbit ears under a microscope to acquire this superb anastomosis ability. Director Han, Director Tian, and Song Zimo all came here this way.
After Tianyuan finished watching the video, he turned the video upside down and watched the key steps again and again, for fear of missing the details.
"You should rest, thank you for your hard work. The quality of the vascular anastomosis is quite high, but don't be careless. Please tell the nurse to pay attention to the blood supply and deal with any problems at any time." Tianyuan ordered that as long as the quality of the operation is good and the patient's medical safety is ensured, there will be no problem.
.
Tianyuan also wanted to say something, but he didn’t know what to say.
"You guys go and rest. I'm going to the operating room. Lao Jin and the others haven't finished yet."
