MTL - Doctor’s Life Simulator-Chapter 69 Li Lianan's final surgery

According to the monitoring of Wu Youtu and You Daren, the MAP of each branch of the external carotid artery is close to that of the external carotid artery, the MAP of the distal blood vessels after occlusion decreases by 17.81%, and the stump arterial pressure ratio can be maintained above 70%. Therefore, it is proved that retrograde It is feasible to nourish the free flap with blood supply mode!

Looking at the data monitored by Qin Lang and others in the operating room, several directors in the observation room were also excited.

Shen Jiaqi clenched his fist tightly:

"In antihypertensive anesthesia, the internationally accepted blood pressure reduction range is 30%, and a blood pressure reduction range of more than 30% may lead to decompensation of blood perfusion in organs, and the retrograde mode is less than 20%, which is equivalent to human sleep at night. Physiological blood pressure reduction in the state. It is enough to show that the branch of the external carotid artery is feasible and safe to use as a retrograde blood supply receiving area.”

At the same time, Shen Jiamo also gave prestige to the lower-level doctors who were still in the First Affiliated Hospital of Zijingang University. Soon, he received the data compiled and collected by the lower-level doctors:

"Everyone, there is another good news. I asked my colleagues to count the stump arterial pressure ratio after occlusion of the descending branch of the lateral circumflex femoral artery in our hospital, which is about 59.69%, indicating that the branch of the external carotid artery is located in the head and neck. In defect repair and reconstruction, it is more reliable to nourish the free flap with retrograde blood supply than the blood vessels at the end of the extremity. This is an amazing result!"

Hearing Shen Jiaqi's specific data analysis, in the observation room, several directors got a closer understanding of the excellence of this technique.

"Director Wei, when I go back, I must report this to our Director Meng, and show this new retrograde blood supply model at this Asia-Pacific International Burn and Plastic Surgery Forum!"

On the side, Dean Hang and Dean Sun are both bright-eyed. If this procedure can be selected into the Asia-Pacific International Burn and Plastic Surgery Forum, it will play a pivotal role in the influence of the first hospital of the city.

"Director Shen, then I will trouble you to recommend more to Director Meng."

In this matter of improving the overall strength and reputation of the First City Hospital, Dean Sun and Dean Hang have the same goal. Internal competition is internal competition, but external interests are always the same.

"No, it's my pleasure."

Shen Jiamo said seriously to the two deans, and was also very excited. This new retrograde blood supply model is also very inspiring to him. Obviously, after returning to the First Hospital of Zijinggang University Affiliated University, he will also start to carry out similar directions. research in order to benefit more patients.

In the operating room, Qin Lang also completed this operation very quickly. Speaking of which, the difficulty of this operation itself is not too big, even lower than the conventional operation, but because of this, it reflects the The clinical significance of this modified procedure.

However, this competition is not over yet.

After the directors communicated again, they continued to calm down and watch the remaining two surgeries, which was also a demonstration of the improved hand surgery.

After watching Qin Lang's two improved surgical procedures, the directors were also very interested in the remaining core surgical procedures of hand surgery.

On the screen, Li Lianan has already started the third operation, and this time, he thinks it is the killer: the free nail flap transplantation to repair the skin defect of the thumb.

Seeing Li Lian'an begin to prepare, Director Tian Bo calmed down and began to introduce the improved technique he carefully prepared, which would save some face.

"...The thumb is an important finger in the function of the hand, and it is also an indispensable finger for grasping objects, accounting for about 50% of the function of the hand. If the skin, soft tissue and part of the bone defect of the thumb are caused by trauma or disease, The function of the hand will be greatly affected, and the traditional treatment is flap repair..."

After introducing this new technique that he improved, Tian Bo's whole personality changed, full of confidence and pride:

"Everyone knows the particularity of the skin of the hand, but without nails, it will have disadvantages such as non-wearability, easy bruising, poor feeling, and poor appearance. Therefore, this time in our hand surgery department, we propose the use of nail flap transplantation to repair Thumb skin defect."

"The toe is the tissue closest to the thumb in the human body. Free transplantation to repair the thumb defect of the hand can not only achieve the purpose of covering the wound surface, but also make up for the defect of bone. Similar. In view of this, in the past three years, our department has conducted clinical trials on 13 patients with skin defects of the thumb, and this time Li Lian’an is showing the 14th case.”

When Tian Bo was introducing, he also announced his own admission criteria. I have to say that the preparations he did were much more detailed and comprehensive than Wei Guoqiang.

It's just a pity that I met Qin Lang who was unreasonable.

"According to the classification method of simple thumb and finger defects in "Repair and Reconstruction of the Hand": 6 cases of first-degree defects, 3 cases of second-degree defects, and 4 cases of third-degree defects, and this time Li Lianan showed a case of third-degree defects. ..."

During Director Tian Bo's meticulous explanation, Li Lian'an also started his presentation in the operating room.

Aside from Qin Lang's performance, Tian Bo's academic ability has been fully demonstrated in the introduction process, and his characteristics of meticulous and meticulous commanding the overall situation can be seen at a glance.

In the observation room, the other directors also sighed with emotion. Director Tian Bo was as powerful as ever, and no one dared to despise him.

Wei Guoqiang also breathed a sigh of relief. This time, thanks to Qin Lang's efforts to turn the tide, otherwise, with his preparations, he would have lost miserably this time.

Moreover, Wei Guoqiang had to admire Tian Bo's exquisite and comprehensive design of the entire technique.

In the operating room, Li Lian'an and his assistants have performed the brachial plexus combined with epidural anesthesia on the patient, and started the operation under the control of a tourniquet.

The first is to debride the collected and trim the bone stump.

Looking at Li Lian'an's operation, all the directors nodded. He was as stable as ever~www.novelbuddy.com~ Of course, compared with Qin Lang's debridement just now, it is still a little worse, but such a young doctor can do it. To this extent, it is also invaluable.

Immediately afterwards, Li Lian'an began to free mark the recipient area and refers to the proper nerve.

Li Lian'an used a very conventional longitudinal arc incision in the patient's snuff fossa to free and mark the deep branch of the radial artery.

Looking at Li Lian'an's orderly operation, several directors have begun to lose interest. After all, Qin Langzhuyu is in front.

Even Director Tian Bo frowned slightly, looking at Li Lian'an's bland operations, which made him feel a little embarrassed.

Next, for the dorsal side of the patient's digital metacarpophalangeal joint, the free dorsal vein was cut and marked for use. The whole process was uneventful.

In the observation room, Shen Jiamo quietly yawned.

In the next step, Li Lianan used the thumb of the healthy side as a standard to measure the area of ​​tissue defect and the length of bone defect.

According to the size and shape of the thumb defect, a flap was taken from the fibular side of the ipsilateral foot toe. During the design process, it obviously exceeded the defect by about 1cm!

As usual, these directors don't think there is anything, but when they think of Qin Lang's precise cutting, Li Lian'an's conventional and conservative enlargement operation seems a bit inferior.

Director Qian Mubai squinted for a while, then took out a piece of candy from his pocket and put it in.

Obviously, these directors are very tacitly prepared, taking advantage of Li Lian'an's surgery to rest for a while, after all, Qin Lang's third surgery is about to start.

PS: Thank you for your vote support and regain the top ten. Thank you for the 100 coins that are all white, 500 coins for YY, and 100 coins for the rain in the northeast. Thank you. It's a bit late because of overtime today, so hurry up and code Chapter 2.