Chapter 527: Fun

"The damage to the index finger of the patient is quite serious, which is not very serious in foster care, but it is much more serious than the standard for replantation of severed fingers. In this case, when we do foster care, we must first consider using Repair the skin flap." Wang Haiyang stood on the chief surgeon's seat, full of vigor.

Ectopic foster care can be said to be the limit operation of microsurgery.

But from this direction, ectopic foster care can also be considered as the current limit operation of human medicine.

One of the reasons why Yunyi Hand Surgery is famous is that it has the extreme level of operation in this direction.

Of course, the most extreme thing is the heterotopic fostering of the palm and arm, and the difficulty of the fingers is lower, but overall, it still represents an extremely high-end level.

The operational difficulty of foster care and various problems during nursing care are basically similar, but there is a slight difference in magnitude.

Most of the hospitals in China, not to mention the doctor's operating level, first of all have to get stuck in nursing and other aspects. Even the hospitals in Beijing and Shanghai, if they don't have enough professional teams in hand surgery or orthopedics, they can't afford to do such surgeries.

Wang Haiyang, who has mastered the technology of ectopic foster care, is qualified to express his pride.

20 years earlier, he was one of the main doctors in Yunyi's research on ectopic foster care.

Wang Haiyang looked at Ling Ran and talked eloquently:

"After understanding this foundation, we will understand that how to choose a suitable skin flap is the first key issue."

"For foster fingers, it is easier to design and use radial artery flaps, dorsal foot flaps, and ulnar artery flaps that are close to the foster fingers or wounds to achieve satisfactory results. Today we chose the dorsal foot flap."

"The reconstruction of the blood circulation of the severed finger, the repair of tissue defects, and the later functional reconstruction are the three major elements of foster care replantation. Generally speaking, the first-stage operation basically determines the upper limit of the entire operation."

It can be said that Wang Haiyang is addicted to teaching "Doctor Ling".

At this time, Guan Fei had already sterilized the patient's feet.

Looking at the patient's tiny feet, Guan Fei had a strange expression, and said, "Long fingers on the back of the child's feet?"

Wang Haiyang, who had just said a long series of words, was preparing for the next set of content, when he was interrupted, he glanced at Guan Fei unhappily,

Ask: "Do you want to listen?"

Wang Haiyang was more patient with pretty girls, otherwise, if it was an idiot male intern, he wouldn't use interrogative sentences at all, and would just "go out" to solve the problem. No "rolling" is because he is getting older, the secretion of testosterone changes, and his temper becomes better.

Guan Fei, who always speaks more casually, has met Director Wang Haiyang several times, and thinks he is a good-tempered chief physician, but she was suddenly reprimanded.

Guan Fei couldn't help lowering her head. A one-year internship was obviously not enough for her to fully adapt to the hospital environment.

Wang Haiyang turned his head after cursing.

He couldn't care less about looking at the pretty little girl now.

At this moment, Wang Haiyang is caught in the most mysterious, joyful and elusive mood of the Chinese people—to be a teacher.

Wang Haiyang happily raised his head and asked Ling Ran, "If you want to make a skin flap, Dr. Ling should be fine."

"Cut the muscle tissue to form a flap? Yes."

"If you can choose, which position do you want to choose?"

Ling Ran recalled, "It can be connected to the dorsalis pedis artery."

"Yes... that's right, I thought about it myself, or did I read the book?"

"I read it when I was studying before." Ling Ran's answer this time came from his own liver.

The potion of energy can not only help him to perform the operation, but the effect of the liver book is actually very good.

As a newcomer to the hospital, Ling Ran really has a lot of books to read.

It can be said that it is very common for a mature doctor to read a stack of professional books equivalent to his height every time he advances a level.

Snapped.

Wang Haiyang stomped his feet vigorously: "That's right. Doctor Ling is prepared. Okay, let's continue... The second phase of replanting is the key and difficult point of ectopic foster care. Generally speaking, according to the need, the dorsum of the foot is cut The skin flap, here mainly maintains the continuity of the foster vessel and the dorsalis pedis arteriovenous..."

Wang Haiyang's explanation is very detailed, even more detailed than what he gave in hand surgery.

From Ling Ran. From Lu Wenbin to the interns, everyone listened very seriously.

However, Ling Ran is still the only one who is really qualified to implement ectopic foster care.

Among the others, Lu Wenbin, who did the best replantation of severed fingers, had never performed the operation independently, and higher-standard ectopic foster care was even more far away for him.

Wang Haiyang talked for more than half an hour before doing anything.

Of course, he didn't listen to his mouth during the operation, so the nurse had to give him water to moisten his throat.

Wang Haiyang couldn't stop being so excited.

After finishing the skin flap, Wang Haiyang was so excited that he wanted to take off his clothes and dance a song.

"Yes, today's ectopic foster care can do it." Wang Haiyang is the chief swordsman in charge of power today, and under the influence of Ling Ran's calm and calm big feeding technique, the effect almost surprised him.

After all, technology is interlinked. Of course Ling Ran doesn't know how to do ectopic foster care, but he has had 100 foot dissections and 3,000 upper limb dissections. With this kind of anatomical experience, it can be said that when you see a blood vessel, you can know the shape of the surrounding tissue, and even look at the state of other muscle tissues and tendons, and you can know the degree of stress on the tissue you are stretching.

With such a foundation, coupled with Wang Haiyang's detailed explanation, Ling Ran was not very clear about the specific steps of the technique, and the general direction was determined. As his assistant, Wang Haiyang flew up as usual.

Theoretically, unless Wang Haiyang has 80% of Ling Ran's skills, and then concentrates on doing fast, and then leaves a lot of auxiliary work to his assistants, at this time Ling Ran may not be able to use the big feeding technique. However, if Ling Ran was given a few more chances to familiarize himself with the spells, then even if Wang Haiyang had Ling Ran's 90% success, he would be blown away.

The intraoperative pressure of the assistant is much lower than that of the surgeon.

The chief surgeon should consider all kinds of problems, such as the condition of the patient, the capacity of the current tissue, the sequence of operations, etc. The assistant only needs to cooperate with the chief surgeon.

If you switch to an ordinary junior doctor or a resident doctor, you may not be able to cooperate well. For a senior doctor who has done surgery for a few years, this kind of situation will rarely happen again.

Wang Haiyang did it for a while, and he was so excited that he wanted to fly. Then he looked around, nodded to someone he knew and said, "Doctor Zuo, go to the hand surgery department and call the doctors in my group to come and see the operation."

Zuo Cidian was free after finishing the debridement of one finger earlier, and quickly agreed, saying: "Will you notify the doctors in your group?"

"People from other groups can come and see if they want to. By the way, college students and interns are also called over. Heterotopic foster care is relatively rare." Wang Haiyang decided to upgrade his coolness.

The best thing about being a surgeon is that when the operation is done well, other doctors come to visit.

Correspondingly, if the operation is not done well and there are many people who see it, the surgeon should scold them.

Zuo Cidian reluctantly stepped back out of the operating room.

He is also very eager to see this operation. As Wang Haiyang said, ectopic foster care is indeed quite rare. Another thing is, the time of other operations, such as Wang Haiyang, a chief physician, will not explain it to you in detail.

When most surgeons are on the operating table, they still like to chat.

Lectures are something that definitely depends on your mood.

If Ling Ran hadn't been listening to the lecture today, Wang Haiyang wouldn't have bothered to talk much.

After a while, hand surgeons came in one after another.

The itinerant nurses struggled to draw lines and control the number of people. In the end, Xiang Xueming and other interns were kicked out.

As long as Wang Haiyang has someone to worship him, it’s fine. It’s more refreshing to keep changing people, and his voice is raised:

"Children's blood vessels are not easy to suture. This little patient is only 10 years old this year. At such a young age, it is rare to do heterotopic foster care."

"The youngest ectopic foster care that our hospital has done should be 7 years old. How to say it, the effect is relatively average. The surgical conditions at the time were not comparable to the current ones, and the microscopes are now better than before. My eyes are old. ..."

"This operation is expected to take 3 hours. If you need to urinate, you are not allowed to urinate in my operating room. Just kidding, it is allowed to urinate in diapers. Don't use too much. If you urinate on the floor, lick it clean."

Ling Ran was thinking while listening to Wang Haiyang's words.

As the operation progressed, he became more familiar with the operation and became more comfortable with it.

The pressure of the operation is reduced, which brings about the increase of thinking.

Ling Ran also doesn't expect the system to assign him a skill in heterotopic foster care, so he has to learn it by himself-in fact, most of the doctors who do heterotopic foster care are driven by ducks.

The amount of this kind of operation is too small, and if you do three or five cases, you can call yourself an expert nationwide.

Of course, there are also those who do more. However, ectopic foster care is a hand surgery after all, and it is more suitable for emergency treatment. Even if you are a mature hand, the window period without similar surgery may be very long.

As far as Ling Ran's current level is concerned, he is already better than most doctors who have done this type of surgery, but he is less experienced than the experienced ones.

"The blood vessels in the foster care part should match the blood vessels in the fingers. It is easy to reveal, which is conducive to the later operation."

"The thickness and color of the skin flap should also be taken into consideration as much as possible."

"There is no need to think too much about the donor area. We just cut such a small piece, which has little impact on the donor area."

Wang Haiyang was extremely excited when he spoke, and the movements of his hands increased.

The doctors around were also staring at the operation and Ling Ran who was performing the operation.

The few interns hiding behind couldn't see the operation area very clearly, so they looked at Ling Ran and whispered to their ears:

"Doctor Ling is really handsome in performing surgery."

"Look at the way Dr. Ling holds the tweezers, hey, look, it feels so good."

"Look at his standing posture. If you want me to tell you, you should release the picture of Dr. Ling performing an operation. There will be no doctor-patient disputes."

"There will only be more doctor-patient disputes. There will definitely be green tea whores who will curse their husbands to death and then sue Dr. Ling for marriage. I have already thought about the plot..."