When Lu Cheng walked into the operating room again, Lin You had already prepared disinfection tools.

Lu Cheng hurriedly put on sterile gloves and lifted the injured hand......

The master and apprentice finished laying out the sterile cloth towel in just five minutes.

Lin You asked: "Do you know why you still use a waterproof sheet today?"

For Lin You's kind of question, which may arise at any time, Lu Cheng has long been prepared in his heart.

But he knew this, so he replied: "Trauma, especially open wounds, usually require a lot of irrigation during surgery. Also, depending on the lesion, VAC may be placed. ”

"Whether or not infection will occur after open wound surgery, some studies have shown that the relationship with whether the debridement is thorough or not is not large, but has a great relationship with whether the debridement is sufficient. ”

Conversely, excessive debridement can also lead to excessive soft tissue loss and affect wound healing. ”

Lin You glanced at Lu Cheng and didn't speak, Lu Cheng's answer naturally didn't disappoint him, it's just that Lu Cheng even did these basic skills well, so this operation, he came to operate, and it would not be a big problem.

Some people feel that the exquisite operation during the operation is the most attractive and powerful.

Not really.

In most cases, the results of the surgery are actually qualitative before the operation.

Then he took the initiative to stand in the position of Ichisuke and shouted to the nurse who was washing her hands: "Normal saline, a thousand." ”

"You do it!" he said to Lu Cheng.

Lu Cheng saw Lin You's actions and knew that Lin You didn't look like he was cheating today.

The patient's injured index, middle and ring fingers can only be opened.

The incision was opened, and the incision was so deep that in some places it even reached the midline of the three fingers and the dorsum of the fingers.

It is important to know that the midline refers to the place where the nerve is out of shape, and if it is injured, no matter how well the tendon is sutured, it will not be able to restore motor and sensory function.

So, this surgery looks simple, but it's not that simple.

Lu Cheng first recalled the basic anatomy of his fingers, and then took the initiative to ask the hand-washing nurse and shouted, "A pair of tweezers." ”

This kind of wound, before suturing the tendon, must be thoroughly cleaned, and the wound and blood scab must be washed clean, otherwise it is extremely easy to affect the surgical field and subsequent operations. Moreover, after washing out the blood scab, it can be clear where the blood supply may not be good.

Also, if a wound like this crosses the midline, it is important not to injure the nerve during the cleaning process.

Because the nerve may not have been cut off, but was rubbed off in the process of flushing, this is the reason why Lu Cheng took tweezers.

Lin You still didn't say a word.

Lu Cheng carefully opened the wounds of the three fingers one by one, removed the blood scabs, and then rinsed them thoroughly with sterile saline.

Just on the ring finger, Lu Chengcheng saw the scarlet bones, and the tendons in between them had been broken, and they were slightly retracted.

It's not a big problem to stitch it up.

However, it is not possible to determine whether the nerves have been injured.

The blood scab is not easy to see and remove, so he can only help with tweezers, and as the water continues to rinse, Lu Cheng did not find the direct severed end of the nerve.

However, there is an extremely subtle digital nerve, and there are some small wounds, although they are not broken, but if they are directly scrubbed with gauze, it is estimated that they will be really broken, or they will not be washed thoroughly, and the red nerve will be easily punctured as a small blood vessel, which will be a big problem.

Lu Cheng was very glad that he was careful.

Continue to rinse the middle finger.

The condition of the middle finger is slightly better than that of the ring finger, and the wound is only to the abdomen of the finger, and there is no need for suturing, so the wound can be closed directly. Moreover, after the blood scab was washed off, there was more blood oozing from all sides, which proved that the blood supply was excellent.

No special handling is required.

Good thing.

But when it comes to the index finger, the problem is a little more serious.

After the wound was irrigated, it was already partially white.

This looks like a sign of ischemia.

Moreover, the tendon of the finger abdomen has also been cut off horizontally, and it has been retracted into most of it, so I don't know if it can be pulled out for the time being.

Lu Cheng's brows furrowed.

If it's so deep, it's likely that the nerves are gone. It's just out of sight.

Lu Cheng's brows tightened slightly at this time.

However, Lu Cheng knew that it would definitely not work to panic at this time, so he continued to operate slowly and carefully.

During this period, Lu Cheng occasionally glanced at Lin You a few times, but Lin You didn't even seem to have the intention of speaking.

Lu Cheng also understood that Lin You was really testing him.

Lu Cheng continued to recall the anatomy, the nerve of the index finger is different from the middle finger and the ring finger, the nerve of the index finger comes from the finger nerve and the hallux nerve, and is in charge of the opposite border on both sides of the index finger......

Although the two nerves come from different sources, the area in charge is actually similar to that of other digital nerves. The patient did not hurt the location of the tiger's mouth, so ......

Must you find them all?

No, it seems that the finger nerve of the index finger is out of shape, and there may be mutations?

When Lu Cheng searched for half a minute and didn't find the broken end, the word suddenly popped out of his memory.

Lu Cheng's eyes lit up suddenly, and then gently, he broke some soft tissues on the side edge of his index finger, which had already passed the distance of the midline.

Good guy, in an instant, Lu Chengcheng saw two big white and chubby nerves lying there intact.

Thankfully, the nerves are still there.

If you don't have anatomical knowledge, I don't know how long I'll look for this nerve today just to suture it.

Lu Cheng immediately covered the soft tissue again and protected it.

He shouted to the itinerant nurse again: "Touring teacher, give me double doses of complexed iodine, hydrogen peroxide, and a large amount of normal saline, at least 1,500." ”

"When you come up, take a needle and thread ......"

"Master, let's sew separately, this can save time, and it can also reduce the patient's anesthesia time. ”

Lin You nodded.

He actually had a false alarm in his heart, after all, he had clearly seen Lu Cheng's operation, but Lu Cheng actually found the finger nerve on the back side of his index finger, which made him exhale.

This is no accident.

Since Lu Cheng will open it to find it, it proves that he knows the shape of the finger nerve and the possible location of the mutated nerve, and these are the basic skills of the trauma department, and they are absolutely solid basic skills.

And these basic skills, even he, a joint surgeon, don't know much about them.

He was even ready to call the attending of the hand surgery to save the scene, after all, nerve sutures, only hand surgery and must be a person who can do microsurgery, an orthopedic surgeon who can do joint surgery, sorry, not too many people can.

This operation, at this point, is actually over.

Children have a strong ability to grow, and after the tendon is sutured, there is basically no need to think about whether it grows up or not, but you have to worry about the problem of growing too fast after surgery and not exercising in time.

But this, there is no need for him to worry, these are all guided by hand surgeons......

"Okay, get ready for stitches. ”