Chapter 221： Weaving

Suturing blood vessels is a very familiar task for Ling Ran.

When he first arrived in Yunhua, the medical administration department used sutured rats' tails to dismount.

Now that I want to come, it is equivalent to let the recruits and special forces compete in sniper shooting, the difficulty is already in the top of the industry.

However, suture the vascular network is still a difficult challenge beyond the normal level.

The blood vessels in the foot are thicker than those in the hand. That is the main arteriovenous vein. The perforating branch artery shunted from the posterior tibial artery or peroneal artery is not so wild. Many of them are thinner than the arteries of the fingers.

The suturing of suturing fingers is only two or three, three or four.

Of course, the actual difficulty is still more difficult than suturing the fingers. Because broken finger sutures have extremely high requirements for the quality of sutures of blood vessels, and the tolerance for low-quality sutures is very low. A bad one is thrombotic necrosis.

The vascular network around the Achilles tendon does not have such high requirements. Academician Zhu Tongyi's plan a, that is, the reconstruction of the vascular network. There are three or four perforating arteries on the inner side of the Achilles tendon and three or four perforating arteries on the outside of the Achilles tendon. Claim.

The most important thing is that even if Ling Ran fails to suture one or two blood vessels, it will not cause too much impact, at least it will not cause Achilles tendon suture failure.

As for the failure of the original plan, for such an experimental operation, there will be many statements of success. If it fails, there is no way to explain it.

Zhu Tongyi stared at Ling Ran's movement quietly, seeming more nervous than Ling Ran.

Ling Ran's operation is more and more relaxed.

I saw that his wrist was soft, and his fingers lightly slid under the microscope. A few times, he sutured a blood vessel, then scooped out another blood vessel, brushed it a few times, and stitched it again.

Ji Tianlu was busy cooperating, and even the second assistant Lu Wenbin kept moving around the operating table, moistened the blood vessels with saline, moistened the gauze, sucked for a while, and pulled the hook for a while. Status.

Everyone frowned, with a **** battlefield, staying up late to make up for the pain of homework.

Only Ling Ran, apparently immutable, flew up in his heart.

This is how to sew blood vessels to living people, and it can sew one net at a time. How cool is this?

If a broken finger is replanted, Ling Ran must first perform debridement carefully, then fix the bones, and then suture the tendon, and then have the opportunity to play with the most critical two or three blood vessels. After playing, stitch the nerves and throw the sutures to other animals.

In Ling Ran ’s sense, debridement is not so interesting anymore. The internal fixation of bones is more like a carpenter's job. If the tendon is sutured, the flexor tendon is still fun. The ordinary tendon is not good enough. The most interesting part of replantation.

Today, what kind of scene did Ling Ran encounter?

Large vascular network, and small and difficult vascular suture.

It is equivalent to taking out the best part of the replantation of broken fingers for Ling Ran to play.

Ling Ran's mood, let alone how happy he is.

This is not the rat tail in the exercise room. Perhaps for newcomers, being able to sew rats once is already very happy, however, Ling Ran has already passed that newcomer stage.

There is a living person who can sew, and it has the cooperation of one help and two help. There are equipment nurses to deliver things, and there are sew-up nurses to help sew. It is more comfortable than sitting alone in the practice room alone.

"Change a little more suture." Ling Ran was happy, and sutured three perforating arteries in one breath. Facing the thinner fourth one, he changed the thread again.

Academician Zhu Tongyi had to remind him, "Your key is to pay attention to dynamic balance."

The implication is that he cannot resew the entire vascular network, and can only choose important blood vessels to form a barely usable vascular network.

This is like after a war, the original meticulous and orderly logistics lines were destroyed by most of the generals responsible for reconstruction. The task of the generals responsible for the reconstruction is not to restore each original logistics line a little bit, but to focus on restoring one. The supply chain is to ensure the supply of the most important materials, and the rest of the supply chain can be completely restored to other people for a longer period of time.

Ling Ran understood the order of Zhu Tongyi very well. He nodded and explained, "I want to make an extra path out."

Unlike ordinary "generals", Ling Ran is in good shape. He doesn't just want to restore a supply chain, he wants to make one more.

"Are there enough time?" Zhu Tongyi looked up at his watch, his expression relaxed a little.

Ordinary Achilles tendon surgery takes about an hour or two. The time on the operating table is two hours long and 30 to 40 minutes short.

Zhu Tongyi's plan a is more complicated. He plans to give the surgeon four hours of surgery. This time is not casually spoken, but a "dynamic balance" made according to the degree of Achilles tendon exposure and so on.

The time is too short for the main knife to complete the operation. If the time is too long, the effect of the operation may be compromised.

Now that the surgery is progressing smoothly, Zhu Tongyi hopes to finish the operation within three hours, so as to ensure a more efficient recovery.

With Ling Ran's progress in mind, Zhu Tongyi felt very hopeful. Even if a backup path was made, it would be possible to maintain the current speed.

Considering that the operation will not be profitable too soon, Zhu Tongyi might as well agree that Ling Ran will sew more blood vessels.

Ling Ran is also very familiar with Zhu Tongyi's plan. His eyes were staring at the microscope, and Xuan didn't want to leave at all. He said, "We don't have many small blood vessels cut off. It is hoped that 30 to 40% of the vascular network will be restored. It is good to restore more Right? "

"Of course, but to ensure the quality as much as possible." Zhu Tongyi reminded "the danger of convulsions still exists, the blood vessels that are open are the useful blood vessels."

The more blood vessels you recover, the more nourishment you get during your Achilles tendon recovery.

The reason why the minimally invasive Achilles tendon surgery can be discharged soon and try to recover is because the vascular network around the Achilles tendon is still there. As long as the Achilles tendon is sutured and the adhesion is treated, it can be restored as before.

Large open surgery in order to ensure the strength of the Achilles tendon does not have such advantages, especially for some special approaches, such as Achilles tendon repair with a median incision of the Achilles tendon, the complications are significantly higher than the Achilles tendon Midline incision. The reason is that the latter has less blood supply and fewer blood vessels are damaged by the incision.

In Zhu Tongyi's plan, the sutured blood vessels must have a certain quality to be effective.

It does not need to be as high as the quality of blood vessels replanted with broken fingers, but it must be of a certain quality.

In fact, Zhu Tongyi's plan a basically sew Liu Weichen's Achilles tendon and made Achilles tendon suture and revascularization, which increased the difficulty by more than ten times. It is even more difficult to maintain quality and quantity.

Zhu Tongyi looked at the young Ling Ran for fear that he could not bear his temper or lost his focus.

This is the most common problem for young people.

Words such as roughness, impetuousness, etc., appear once the blood vessel is sutured.

However, Ling Ran did not care about Zhu Tongyi's instructions at all, steadily sutured the blood vessels, and said, "to ensure the quality."

Ji Tianlu couldn't help looking up at this moment, saying "Dr. Ling is fine."

I wish Tongyi wake up and quickly said, "Concern is chaotic. I care a little bit about our plan."

Shown in the classroom.

Listening to the boss of the research center, the absolute banner wished Academician Tongyi to say such a thing, and the doctors were already in an uproar.

Dr. Qu couldn't hold back the emotions in his heart any longer, and said indignantly, "It is really a foreign monk who reads the Scriptures well, and the director speaks too well."

"That said, the tone is wrong."

"Hey, hey, don't go online, we wish the academician didn't say anything?"

"What do you want to say to the academician? That's enough. You have to figure out that the plan is for our academician. This is to guide the operation. Ling Ran is just the main knife."

The 203-pound resident smirked with mineral water. "Is Ling Ran just the main knife? It's just that?"

The doctors who were still impassioned just shut up wisely.

Showing off among colleagues is very difficult, let alone a professional doctor in a department.

If you are facing outsiders, you may still have something to say. When facing your own people, everyone ’s positioning is relatively clear ~ www.novelhall.com ~ Ling Ran ’s main knife can be said to be out of the research center It can also be said that the research center is really unable to take out the people and is supported.

But no matter how you look at it, Ling Ran is currently occupying the strongest position.

The 203-pound resident was unwilling to downplay his opponent.

He is also afraid of the strength of his opponents, but he is willing to face the gap between himself and Ling Ran. Ling Ran's technology is strong, his talents are good, and he may be a first-class surgeon in China, but ... the doctor will continue to grow!

The 203-pound resident has set a detailed goal for himself. After waiting for this, he will retreat and practice in the shortest time to catch up with Ling Ran's technology.

At that time, he will definitely find another opportunity to defeat Ling Ran, and then bring a pair of pure-bred French lop-eared rabbits to Xiaoyun.

The 203-pound resident doctor thought of this, and excitedly filled a full bottle of Nongfu Spring, and comfortably shot a 204-pound fat man to make a full meal.

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