Chapter 106： Nerve bundle anastomosis

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"Li Huamin, are you?"

"Yes. 31-year-old woman, pierced her palm with a hard object after falling ..."

Ling Ran entered the operating room, asked a question, and listened to Lu Wenbin's report. He first probed his brain and watched various films.

He did not have such a requirement before. Since he had it, the operating room of the emergency department has specifically added a large mobile backlight panel.

A hospital is such an institution. Your technical level is high enough, and you have whatever you want. If not, it means that your technical level is not high enough, to put it plainly-how much does it cost to buy a life? How much does it cost to buy your own hand?

In the face of high-level doctors, hospital investment has always spared no expense and qualified to be the leader of the hospital's decision-makers. It is also clear enough that high-level doctors cannot simply calculate the revenue from surgical and medical expenses.

Of course, the level of high-level doctors must be very high, far exceeding the average level of doctors.

In this regard, doctors are much like athletes.

Doctors of ordinary level are just like athletes of ordinary level. In order to reach level two and level one, they will feel tired and die, but they will not suffer. However, who cares? who knows? Who cares?

They can only reach the level of 5 years, 8 years, or even 10 years. Outsiders are too lazy to look at them, and insiders just use them as cornerstones. The value is similar to small stones.

A high-level doctor, more like a high-level athlete, is at least qualified to win a place in the provincial games.

In the larger third-class hospitals, this requirement is still higher-you must be eligible to participate in the National Games, at least at least, there is potential, in the next few years, hope to grow to such a degree.

Ling Ran obviously did.

More than 100 cases of tang method are his confidence.

The hospital leaders did not use too much spirit to compare, and they took Director Pan as a benchmark to draw a bottom line for Ling Ran's value.

Director Pan is already a well-known expert in hand surgery in the province. It is not so famous, but the famous one is required in related meetings of hand surgery in the province. If there is a national flexor tendon-related and tendon-related meeting, he must also be Can get the invitation letter.

On the tang suture alone, Director Pan is one of the top specialists in Changxi Province and the first choice for referral in the industry.

Ling Ran is just a short time to Yunhua, and his identity is slightly embarrassing. As a result, Yunhua Hospital's bureaucratic system has not yet been operated and a final decision has been made.

However, within the emergency department, Ling Ran has enjoyed quite high treatment. The right to use the operating room for the entire period, the full amount of surgery fees, the full commission of medical consumables, half-time full-time assistants and training programs, and so on.

Of course, Ling Ran's ability is even more surprising.

Patients who have been continuously discharged with "Excellent" ratings are placed in any hospital in the country, which is an amazing achievement.

Lu Wenbin is now looking at Ling Ran, and they are all afraid.

"The ulnar nerve is damaged, isn't it?" Ling Ran has watched the film before, and now ask one more question to confirm it.

Lu Wenbin froze for a moment and said, "There is nerve damage in the ulnar nerve groove."

Lu Wenbin is somewhat accustomed to Ling Ran's style of doing things, but he rarely sees his concern about nerve damage.

Some small nerve injuries can be avoided without sutures. A little larger ones can be sutured or not, and more serious, so-called combined nerve rupture, will not be sent to Yunyi Emergency Section is here.

Professional departments in modern hospitals will screen for diseases. The more complicated diseases are sent to Yueniu's hospital, and ordinary hospitals only make their own familiar cases to improve the success rate.

Ling Ran did not do nerve suture before, and he would screen out cases with severely damaged nerves, as well as those with more severe fractures.

He can do it now, and when he encounters such patients with surgical indications, he can perform sutures.

"After the tendon is sutured, he will be sutured with the fascia of the ulnar nerve." Ling Ran quickly made a decision.

The so-called surgical indication means that the disease meets the standards prescribed by conventional surgery. The surgical indication of hand nerve injury is actually very low, because the primary suture (for early good wounds) has a good effect on nerve injury.

Furthermore, it is self-evident that a sutured nerve is better than a non-stitched nerve.

However, there are few doctors who like to suture nerves, especially in departments other than neurosurgery, which can often be done without sutures.

The first reason is naturally difficult to sew. In simple terms, hospitals other than the top three can scarcely sew nerves. If the stitching is not good, it is better to not stitch.

Ling Ran did the same before. Without diamond diamonds, he wouldn't take porcelain.

Now he has got diamonds.

Lu Wenbin hesitated to start preoperative preparation.

Ling Ran watched the film for a while.

A large number of magnetic resonance films and x-ray films were inserted into the backlight, which seemed quite confusing to the layman, and Ling Ran looked with interest.

The reading ability and experience brought about by master-level magnetic resonance films are, to the clinician, like opening the eye of the sky, without anatomy but the clearness of anatomy. Once used, it is inseparable. This is much more useful than just a few words from an imaging doctor. Even the imaging doctor himself cannot get a lot of information that Ling Ran can get without knowing his specialty.

In the future medical environment, the requirements for doctors' reading ability will definitely be higher and higher, but for now, popularization is still very difficult.

Undergraduate medical students do not do special training, they must look at magnetic resonance, such as heavenly books.

Ling Ran's master reading ability is stronger than most imaging doctors.

In order to do his first case of nerve bundle anastomosis, Ling Ran looked for a long time and looked very carefully.

Ling Ran was thinking about the order of suture of tendons and nerves, the development direction of the incision, and so on.

In the past, the tang method was a fixed technique and a fixed order, which did not involve anything else. It was done step by step.

Adding nerve anastomosis is different.

This is like the original plan to build a bridge, but now an overpass should be built. The bridge can be designed step by step, and the overpass must be considered according to local conditions.

Although Lu Wenbin and others were a little strange, they were still as quiet as cats.

"Let's get started." Ling Ran returned to the operating table, expressing expressionlessly, "Reconstruction of flexion function, combined with ulnar nerve anastomosis. Today's surgery is different from usual, and you need to get up."

Ling Ran gave a special reminder, and began with a bow-like opening, gently opening a large twelve-centimeter-long mouth.

Lu Wenbin's eyes were fixed.

The resident doctor has been doing this for a long time. Looking at the opening of the main knife, sometimes you can guess a lot.

Regardless of personal habits, the same main knife in the same operation, the larger the opening, the more difficult the operation.

Ling Ran was a doctor who paid great attention to the beautiful appearance of the mouth. At this time, a super-standard mouth was drawn, and Lu Wenbin was immediately awakened.

Needless to say, Ran Wenbin rushed into the battle with gauze.

Ling Ran opened the patient's muscle layer steadily and slowly, without speed.

Lu Wenbin was more competitive and actively participated in ~ www.novelhall.com ~ Familiar flexor tendon suture, even though Ling Ran deliberately stabilized, it was quickly completed, followed by the nerve bundle anastomosis.

The nerves of the human body are structured like a network cable.

The core is multiple bundle membranes. They are the parts that play a role, like the twisted-pair wires in the network cable, and the outer membrane is like the skin of the network cable.

The difference is that because of the biological nature of the nerve, it is capable of self-healing.

Based on this, there are usually three types of nerve anastomosis, namely adventitia anastomosis, fascia anastomosis, and adventitia anastomosis at the same time. The most commonly used is anastomosis, which is to sew up the skin and grow inside.

Good or bad, the doctor can have some control, but not full control.

Beam membrane anastomosis is more controllable, but more difficult. Outer membrane sutures can often be made with the naked eye, and beam membrane sutures are completely impossible.

Lu Wenbin looked worriedly at Ling Ran wearing microscope glasses.

He didn't wear a microscope, so he couldn't understand Ling Ran's operation. He couldn't even see the connection, and the 10-0 sutures were really elusive.

"The beam membrane is really tough." Ling Ran said suddenly.

Lu Wenbin froze for a moment, and asked curiously, "Tougher than pig skin?"

Ling Ran thought about it and said, "It's much tougher. It's like pigskin."

Lu Wenbin knew it.

"Okay." Ling Ran tied the knot quickly with a needle holder and announced that the suture was complete.

Lu Wenbin was surprised: "Just sewn? There are several beam membranes."

"It's all stitched up." Ling Ran sighed, and then began to close the wound.

Lu Wenbin, who had been ready to sew the skin, stayed for a while, and then he continued to beat her obediently, comforting herself: Today's surgery is more important, and Dr. Ling attaches more importance to it. Don't be afraid. It's a technical adjustment. Don't be afraid.