"Brother Ye, the first two days, so comfortable."

"I feel that performing sutures on patients is more hands-on than in the practice room." In the orthopedic practice room 801, Lan Tianluo had just finished stitching up the corresponding practice equipment, and said while wearing gloves at this time.

As he spoke, he pulled his gloves and flicked them, making a slight snapping sound.

"That's natural, the direct contact of all operations is the patient, and there is nothing to replace the opportunity to operate on the patient, unless you make a knife for yourself." Fang Ziye was also tidying up his operating table and found that a pair of tweezers were missing from today's instrument practice bag.

was about to get up to get it, but Lan Tianluo was quick-eyed, and neatly sent the tweezers of his operating table to Fang Ziye's countertop: "Brother Ye, I have an extra handful in this bag, it should be that the teacher in charge of the equipment made a mistake when loading the bag after disinfection." ”

"It's a pity that I don't have such a good opportunity today!" When Lan Tianluo sent the tweezers, he sighed slightly.

At this moment, Luo Tingzhu walked in from the outside, twisting the pork he had just brought back with his left hand, and the pork belly was twisted in his hand, rotating left and right to observe. In his right hand, he was holding the frozen box that Fang Ziye had brought to practice suturing.

As he walked over, he said, "Senior brother, the number of people in the practice room has been small recently, so the teacher in the warehouse has not prepared extra jelly, just such a small box." The teacher asked me to tell you something so that you could save some money. ”

"I've worked hard to listen to bamboo, I originally said I got it in the past." Fang Ziye took it with both hands, and without touching Luo Tingzhu's hand, he took off the square box and buckled it on the operating table.

The skin jelly is laid upside down on the countertop like a button of meat.

On weekdays, the teachers in the warehouse will prepare more when boiling the jelly with jelly powder, so that students can practice every day.

The price of skin jelly powder is not expensive, and you don't need to spend money to get it, but each person's share is also up to two boxes, and after cutting, you can barely operate ten times if you save a little.

Now that the orthopedic annual meeting is imminent, most of the senior physicians have either gone out for a meeting, or have been put on hold in the clinic, and almost no one has come to the practice room.

I heard that such practice materials as skin jelly are still useful in the second practice room in several wards, and it is understandable that in the absence of these senior doctors, the amount of boiling is less every day.

Today, Fang Ziye evenly drew seven knives of skin jelly, so that the front and back sides were sutured at the same time, so that Fang Ziye could complete fourteen sutures, which was relatively economical.

"It's just a matter of getting started."

"By the way, senior brother, let me give you the cells to be resuscitated, I have already resuscitated you, and put it in the third compartment at the bottom right of the incubator in the cell room, with your name written on it. When the time comes, pay attention to the passage of the generations. Luo heard Zhu say this, and turned around and walked next door.

In the first two days, Fang Ziye and Luo Tingzhu were almost full of customs clearance in the department and emergency operating room, and the other two junior doctors of the professor's group practiced separately in the practice room.

There are three days left, and there is nothing to do with Fang Ziye and the others.

At most, Senior Brother Gu Yi will operate more in the operating room under the leadership of Qin Geluo.

Therefore, at this moment, the practice room of trauma surgery belongs to the special session of Luo Tingzhu, Fang Ziye, and Lan Tianluo. Shu Lang is on duty in the department.

After Fang Ziye finished cutting the skin jelly, he turned his head to look at Luo Tingzhu and said, "Tingzhu, tonight, I want to invite Brother Jin Hongzhou to dinner, you and Tianluo are going to AA together?" Or how to put it? ”

Lan Tianluo nodded without thinking much: "I can be my senior brother." ”

Luo Tingzhu hesitated slightly, his eyes blinked twice, and then nodded: "I can too, Senior Brother Fang, have you already found a good place?" I didn't even think about it in that direction. ”

"It's still senior brother, you think about it thoughtfully." Luo listened to Zhu's crisp voice and was a little embarrassed.

The annual meeting is five days.

Jin Hongzhou let Fang Ziye, Luo Tingzhu and others have a large number of operation opportunities in two days, definitely not to give face to Fang Ziye and Luo Tingzhu, but to Professor Deng Yong, the director of the ward.

In contrast, the junior doctors in Jin Hongzhou's own teacher's group and Professor Han Yuanxiao's group only had three days to operate, and it was Fang Ziye and Luo Tingzhu who took advantage.

But Professor Deng Yong's face, that is the professor's, that is the ward director's.

Jin Hongzhou gave him a chance to carry him, and Fang Ziye still had to express himself, which didn't mean that he had to lick him.

Inviting guests to dinner and increasing the impression is regarded as a courtesy. No, in fact, it's not a big deal, but if there is, it will make Jin Hongzhou's perception of Fang Ziye better and his memory more profound.

In this way, Fang Ziye is still reliable, so when he cooperates in the future, Jin Hongzhou will definitely think of such a delicate little brother.

Moreover, even if Jin Hongzhou can't think of it, it doesn't matter.

Fang Ziye thinks that this arrangement is very good, at the right time, in the right capacity, to do the right thing, and to do things that are beneficial to himself, it is called sophisticated and mature.

In other aspects, Fang Ziye felt that it was not necessary.

For example, at a big party, if you give someone a few glasses of wine, he will take a sip of your mouth, and others may not remember you, and they will not think that you are giving him any face.

"Brother Zhou is the direct superior of all of us, there is such an opportunity that can still be seized, and Brother Zhou may not have the time, and he may not agree, I just think so on my side."

"I'll send you the location later." After Fang Ziye finished speaking, he focused his eyes on the stitching of the skin jelly.

The suturing of the skin jelly is more brittle than the previous tofu cut surface suture, and the slightly force control is not good, whether it is the tip of the needle or the sutures, the skin jelly will be cut.

Moreover, skin jelly is a Q-elastic substance, which is much less viscous than tofu, and it is necessary to put a small suture force at the same time, and it is necessary to accurately control the angle and strength of needle insertion, needle threading, and needle crossing.

Fang Ziye had done it many times before, and he felt that it was very tricky.

However, now that Fang Ziye's suturing technique has reached level 4, I think that Luo Tingzhu has already completed the skin jelly suturing, and he will not be bad.

Fang Ziye wore silk thread with a triangular needle, held a needle holder, first made a few strokes in the air, and then picked up tweezers to prepare for assistance.

If you want to talk about the suturing of the skin jelly, when the tweezers clamp the skin jelly, you also need to pay attention to the control force, a little force, the skin jelly will definitely crack directly.

A stitch through, crisp and neat, without hesitation.

Fang Ziye felt that today's needle entry and needle output, including the angle of the thread, were well controlled, and the skin jelly was just right, leaving only a hole equal to the maximum diameter of the needle.

Moreover, in the process of pulling out the line, there is no crack on the edge of the skin jelly or being 'digging block', which looks comfortable when stitched.

Immediately after that, we came to the more critical point.

Suture and tie the knot.

Suturing and tying knots is a basic operation, and it corresponds to the real knotting technique.

Of course, the stitched knot is slightly different from some special knots, and the stitched knot does not require so many bells and whistles.

The knotting of some special parts, for example, when the operation vision is insufficient, it is necessary to slide the knot from the body surface to complete the operation of strapping, which is the category of knotting.

However, the operating space for suturing and knotting is very large.

But you also have to control your strength, otherwise, the skin jelly, which is more tender than Luo Tingzhu's face, can't stand the toss.

Fang Ziye uses the method of knotting instruments.

After the sutures are properly tightened and close to the surface of the jelly, it is also necessary to complete the temporary fixation of the first knot without auxiliary fixation, which requires the knot of the sutures to be pushed to one side of the entry or exit of the needle to complete the temporary fixation.

In the past, Fang Ziye's operation was not so smooth, but today, Fang Ziye's technique seems to have been clicked by the gods, so it is also extremely smooth.

Even if the second fixed knot has not arrived, the first temporary fixed knot has been pushed to the end of the needle mouth, which is just close to each other and has not been loosened, so that Fang Ziye has enough time and energy to prepare the second fixed knot.

Fang Ziye used the needle holder to reverse it, and the second knot was fixed instantly.

With a click, the thread is cut out, the first stitch is stitched, and this is the end.

After reading it, Fang Ziye was very satisfied, and gently patted the surface of the jelly with a needle holder, and the jelly bounced, but the sutures pulled the surface of the two cuts, and the force was transmitted to the jelly on the other side.

This proves that Fang Ziye's previous stitches have completed the fixation between the two pieces of jelly, and can tolerate the transfer of force and vibration between the two pieces of jelly, and they are very tightly together.

This is a high-quality stitch.

With the confidence of the first stitch, Fang Ziye honestly stitched up seven or eight more stitches, and he was in a good mood.

Arched, the suture operation has not been pulled across.

At this moment, Lan Tianluo happened to sew up a broken orange peel, sighed, and stretched his waist.

At the same time, he also looked at the two big fingers curiously, and saw that on Fang Ziye's side, the stitching of the first frozen cut was about to end, and they were all stable.

Taking a closer look, Lan Tianluo's pupils shrank instantly, and his upper and lower eyelids closed.

Now, he is no longer a little Mengxin who just came to the practice room, and he has seen a lot of performances by his brothers and sisters, so he won't make such a fuss, but he also knows that Fang Ziye's current suturing skills have once again made great improvements!

Shocked in a low voice: "Senior brother? You just got the sutures through so quickly? ”

The last time, in August, when I had just entered the department, at that time, Fang Ziye had just completed the suturing of the orange peel, that is, the suturing operation he had just carried out.

Then, Fang Ziye completed the stitching of the tofu again, and poked out the first practice room for the master's level all the way.

Up to now, it has only been a month, and Fang Ziye has truly passed the first practice room in the suture technique.

Even the first practice room and the last practice material of hand surgery are skin jelly.

After Luo Tingzhu heard the words at this moment, he also completed the operation of cutting a muscle from the pork piece, paused the interval, and looked at Fang Ziye's side.

The movement of his hands froze in the air, and his eyes showed a completely unbelievable color.

When she was a little emotional, her chest rose and fell slightly thicker than before, but she didn't speak, because it would disturb Fang Ziye's operation.

Then, Luo Tingzhu temporarily put down the tweezers and scalpel in his hand, and together with Lan Tianluo, they turned around, just like before, when Fang Ziye watched her operation, then Fang Ziye was an audience.

In the practice room, everyone loves to watch others operate.

The operation is better than himself, I love to watch, see how he operates, and the operation is exquisite.

If the operation is worse than your own, you love to watch it more, and this kind of thinking logic is somewhat similar to the feeling of watching others take the driver's license test just after the driver's license test, which is difficult to describe.

Just two words to describe it, love to watch.

On the contrary, people who are about the same level as themselves do not like to watch it when they are doing operational exercises.

MD, as if he saw Nana's self......

Another five minutes later, Fang Ziye stitched up the twelve stitches steadily.

The width of the jelly is not wide, only about eight centimeters.

Fang Ziye chose a stitching spacing of about 5mm, which is smaller than the customs clearance requirement.

Because the general suture is about 1 cm of stitch length. But this is practice, when practicing, if you can have a few more stitches, you can stitch a few more stitches, after all, if the material is not enough, you have to save money.

"Senior brother, congratulations!" Luo Tingzhu was holding his hands behind his back at the moment, and gently patted his buttocks with the back of his hands to show his nervousness.

Because from this moment on, it was a landmark event, that is, the corresponding operations that he was proud of were all caught up by Fang Ziye.

And Fang Ziye, whether it is in terms of professional operation, or topics, or the breadth of skills, and even in terms of the number of articles, under Lan Tianluo's half-feeding and half-cooperation, has surpassed her.

Well, her manual reduction technique is now inferior to Fang Ziye, and the only leading suture technique has also been equaled by Fang Ziye.

At the same time, her incision is still not proficient in the next step, and the progress of leading Fang Ziye is completely meaningless.

In this way, if Fang Ziye really wants to compete with her for the opportunity to stay in the hospital or something, the emergency department, pediatrics or anesthesiology department is her destination!

The emergency department does not have high requirements for articles, and many people are reluctant to go because they are tired.

Pediatrics doesn't have to explain.

The number of doctors in the Department of Anesthesiology is very small, and excellent masters have a certain chance of staying in the hospital. Moreover, the development of surgery in our hospital is very fast, where are so many doctors introduced?

Most anesthesiologists do not choose to study for a Ph.D., but choose a job as soon as possible.

"Well, for a month, I kept asking Tingzhu and Senior Brother Yuanqi for advice, and you were all impatient, so I am today." Fang Ziye stood up straight, not arrogant or impatient.

After the operation, put down the needle holder and tweezers. Calm down.

If the mind is not quiet, it is not suitable to continue further operations.

Fang Ziye's words are not right or wrong.

That's right, Luo Tingzhu and Wang Yuanqi did tell Fang Ziye a lot of skills, which was not hidden, teaching in the teaching hospital is an atmosphere and a kind of inheritance.

It's just that Luo Tingzhu not only gives advice to Fang Ziye, but also to Senior Brother Gu Yi, and even to Li Yuanpei, and to the new Senior Brother, Yan Zhiming, will also give advice.

There must be a meaning in pointing, but it is still impossible to say how much such a meaning is.

"Senior Brother Fang, it's your talent that is good, much better than all of us." Luo Tingzhu squinted his eyes, a little envious at the same time, but also appreciative.

Fang Ziye said: "Tianluo, you can calculate it for me, I am twenty-seven years old this year." Tingzhu is twenty-three years old this year, and the level of stitching between the two of us is about the same, and her talent is about how many times that of mine? ”

Lan Tianluo said almost without hesitation: "At least 1.6 times." ”

"Senior Sister Tingzhu has only been in contact with medicine for five years, and it is less than five years, and Senior Brother Fang, your time in contact with medicine is less than eight years."

"Of course, we also have to take into account these factors, Senior Sister Tingzhu arrived before you to suture the skin jelly, and Senior Sister Tingzhu arrived very early after entering the school."

"If you want to calculate the number of days you want to learn suture......

Lan Tianluo really went to forget it, Fang Ziye interrupted and said, "Okay, okay!" ~ Brother, we don't need to be so rigorous. ”

Fang Ziye was a little painful, but he didn't expect Lan Tianluo to really be able to give a certain basis.

Luo listened to Zhuzhu for a moment and continued to return to his operating position.

After Lan Tianluo was interrupted, he was not angry, he just held the fist of his right hand and cheered himself on: "I can do it too!" ~”

Because Lan Tianluo also completed the calculation for himself, the time he had been in contact with suturing was actually less than three months, after all, he was only engaged in theoretical study before......

Two hours later.

Fang Ziye got 0.2 points of knowledge points, and at the same time, he finally stitched up this row of skin jelly incisions.

Seven incisions, seven cuts, fourteen rows of sutures on the front and back, twelve stitches in each row, a total of one hundred and sixty-eight stitches, and Fang Ziye failed to suture three stitches.

This success rate is already higher than 90 percent.

This kind of suturing technique breaks through the requirements of suturing and is properly arranged.

After Fang Ziye finished stitching, he couldn't wait to take a photo, and then turned it over and continued to take a photo.

After all, it was the first project that I passed the first practice room, which is commemorative.

And this, although there are a large number of patient assistance, it is also for Fang Ziye to see that the difficulty of wanting to pass the first practice room is high, and the gold content of passing the practice room is huge.

His own teacher, Yuan Weihong, was able to clear the customs before graduating from the doctorate without any assistance?

And other people, the teachers who stayed in the hospital after Yuan Weihong's class can also clear the customs, this talent?

Fang Ziye backhanded them all silently in his heart.

The time came to 10:49.

Luo Tingzhu, on the other hand, had already completed the practice of incision, and at this time he had already gone to the direction of the artificial joint console over there for manual reduction, and clicked back and forth.

Sweating profusely.

Actually, relatively speaking, girls are really too disadvantaged to do manual reduction.

After all, compared to their peers, girls are a little less powerful than men, except for special groups.

Therefore, even if it is a manual reduction exercise of artificial joints, it will still make Luo Tingzhu feel quite difficult. Ke Luo Tingzhu did not give up and continued.

Fang Ziye moved his shoulder joint, planning to get pork as well, and by the way, he practiced incision.

At this moment, at the door of the practice room, a head sticks in.

"No one?" While watching, he was still talking to himself.

"Oh, there is! ~”

This head, Fang Ziye knows, is an attending officer of the hospital's hand surgery, named Yang Wenzheng.

"Brother Zheng." When Fang Ziye saw Yang Wenzheng, he shouted politely.

Fang Ziye is a first-year master's degree and went to hand surgery for residency and training.

Professional master's students need to be integrated into the standardized training rotation program for residency for a period of 33 months, and several specialties of orthopedics and spine surgery, you need to go for at least one month to collect the diseases that you are required to complete during the residency training.

Naturally, there are also gastrointestinal surgery and hepatobiliary surgery in general surgery, which are all departments that orthopedic residents must rotate......

Yang Wenzheng is not very familiar with Fang Ziye, Fang Ziye has only been there for a month, even if he was only hospitalized at the time and had contact with Fang Ziye, he still has no memory.

"Hello. Which of the three of you is free? Can you come and help me help? In the other practice rooms, there was no one. Yang Wenzheng asked.

Luo Tingzhu was a little tired at this time, but Lan Tianluo didn't dare to speak on the operating table, but still continued to operate by himself, an ordinary social type of small residence and training, out of the current department, no one knew him, so naturally he didn't dare to talk.

So it could only be Fang Ziye, and Fang Ziye called out the other party's name in advance.

"Brother Zheng, can I clean up the countertop a little and come over? It's 807, right? Fang Ziye asked.

801-805 is the first practice room of the five subspecialties of orthopedics, while 806 and 807 are the second practice rooms of trauma surgery and hand surgery, respectively.

"Well, okay, you can come over later, mainly to help me clamp the rat's tail and cut the thread." After Yang Wenzheng finished explaining this, he said, "Don't go, you two, wait a while, we'll have dinner together." ”

It is estimated that Yang Wenzheng is also embarrassed, and he called someone to help him practice the operation, so he should have a meal to express it.

And Yang Wenzheng is also a thief, he directly called three people at once, and he was embarrassed to unilaterally refuse.

Fang Ziye lived in Bengbu at that time, and secretly scolded in his heart, these superiors are all human spirits, including his own arrogant master.

I learned another hand.

Ten minutes later, Fang Ziye cleaned up the operating table, cleaned the instruments and packed them, and sent them back to the warehouse.

There was no one inside, and now most of the people in the department are gone.

There are many people left behind in the trauma surgery department because of the emergency department, but it is estimated that the hand surgery department also has operations such as finger amputation and replantation, so most of them are immersed in the operating room.

In the practice rooms of joint surgery and orthopedics, there are no assistants.

Fang Ziye symbolically wore a pair of examination gloves while entering, but in the practice room, there was no need to use sterile surgical gloves, waste.

After Fang Ziye put on gloves, he sat down opposite Yang Wenzheng in a proper manner.

In the second practice room of hand surgery, there are two microsurgical operating scopes.

Yang Wenzheng asked Fang Ziye to put the mirror on, and said, "You look a little familiar, what do you call it, little brother?" ”

"Brother Zheng, my name is Fang Ziye, and when I came to the hand surgery rotation before, we were a group."

When Fang Ziye mentioned this, Yang Wenzheng immediately had an impression: "Fang Ziye is you, the founding disciple of Viagra." ”

"It looks very delicate, it's a little hard for you today, I'll do a broken tail replant, and I only cut a dozen sections today."

"You're mainly helping me fix it, and then it's just cutting the threads, and then these are ......"

Yang Wenzheng first gave Fang Ziye a general idea of the corresponding operating tools.

In fact, it is similar to the operating tools of trauma surgery, but it is much smaller, and the sutures used in suturing exercises are not silk threads, but 12-0 I don't know what threads, but they are certainly not the kind of vascular or nerve sutures used in clinical patients.

Just kidding, can you afford to use those dozens of dollars a stitch in the practice room?

"Okay, Brother Zheng." After Fang Ziye sat upright, he began to operate as an assistant.

Naturally, the cooperation is not so skilled, but Yang Wenzheng is not so annoyed, and after patiently explaining to Fang Ziye twice, Fang Ziye's fixed clamping is quite good.

Then, after wearing a miner-like microsurgical scope on his microscopic head, he said while watching Yang Wenzheng use a thin needle and start stitching the blood vessels and skin of the rat's tail.

"Ziye, it's better for you to have trauma surgery, you don't need to be so fine, like our group in our department, Professor Ni said, the arteries and blood vessels on the rat's tail have a patency rate of more than 99% after suturing to be qualified. After another year or two of clinical practice, it is possible to go to the operating table independently. ”

Fang Ziye was stunned for an instant.

The arterial blood vessels on the rat tail are only 0.2 mm at the thinnest, and the patency rate after suturing reaches more than 99% to be qualified?

In hand surgery, do you want to become a doctor who performs finger amputation surgery? Isn't it?

"In addition to practicing suturing, you also have to practice blinking kung fu, and the master surgeon must practice blinking up to 3 times in 1 minute!" Yang Wenzheng looked at Fang Ziye and kept blinking, so admonished.

Fang Ziye's first reaction, if this is the case, then his eyes are really blind.

However, Yang Wenzheng said so, and Fang Ziye still respected their habits.

It's just that after more than ten seconds, Fang Ziye couldn't hold it anymore, after all, there was strong light under the microscope, and this had to be practiced deliberately.

Yang Wenzheng stitched it stitch by stitch.

In the same way, it has failed again and again.

Either there is blood leakage, or the blood flow pass rate of the instant blood flow meter is not enough, it may be that when the suture is sutured, the blood vessel is folded, resulting in poor blood flow, forming turbulence, and the pass rate is slightly reduced.

Basically, Yang Wenzheng's blood vessel suture pass rate hovers around 70 to 75 percent without blood leakage.

When there were only the last two sections left in the stitching, it may be that Yang Wenzheng is tired, or he may not want to fail anymore, so he throws away the instrument in his hand.

"Come on, there are two paragraphs left, you can do it, I'll book a place first, and after you get two stitches, we'll go to dinner together." After Yang Wenzheng instructed, he unfastened his gloves, then found a phone number and dialed it.

Actually, it's a place to book a meal, and it's a little late, but it doesn't matter, you should be able to leave at about one o'clock.

It's only 12:55 a.m.

Yang Wenzheng's words were something Fang Ziye didn't expect, but the other party gave him a chance to play, and Fang Ziye didn't care, he took over the other party's microscopic needle holder and microscopic tweezers first.

Slenderness is Fang Ziye's first impression of these two devices.

Of course, the stitches are also very thin, probably thinner than a human hair.

The suture needle is not large, and if it were not for the help of a twenty-fold microscope, it might have penetrated into human flesh, and it would not have been found.

Tail vascular suture, in fact, is not to cut off the tail, but to separate the tail blood vessels in advance, start suturing from far and near, and then suture while looking at the passage rate of the blood vessels.

Naturally, the more powerful doctors will also look at the passage rate of all blood vessels after the end of the sutures.

The angle of the stitching is extremely particular.

With such a thin blood vessel, you can't afford to suture multiple stitches, generally four stitches, which is the limit of the number of stitches that the blood vessel can hold.

Fang Ziye twisted the needle, and then clamped the hemostat upstream of the blood vessel to cut off the blood flow, Fang Ziye hurriedly followed Yang Wenzheng's example and cut a flat hole again.

It's not that hard.

Yang Wenzheng saw that Fang Ziye was still operating, and he was also very patient to put on his gloves again, he knew that a little doctor like Fang Ziye was very curious about such a sophisticated technique as suturing a broken tail artery.

Perhaps, such a high-precision technology is an operation that a little doctor like Fang Ziye may not be able to access in his lifetime, and curiosity and refusal to admit defeat are the best raw materials for being beaten.

Yang Wenzheng politely used heparin saline to help Fang Ziye drip a few times, flushing out the blood near the broken end of the blood vessel, and at the same time, to avoid the blood clotting in the blood vessels.

The first priority in practicing small vessel suture is to have clear blood vessel exposure and clean operation area.

Fang Ziye held the suture needle with the needle, and his first reaction was, why is it so far away?

The distance between the operating point of the needle holder and the holding point is very long, which is not conducive to operation. However, after shaking in the air a few times, Fang Ziye also felt that it was actually okay.

Gently pull the end of the blood vessel with tweezers and try the tension of the blood vessel.

This is because when a blood vessel ruptures, it retracts to both sides, and the degree of retraction is related to the diameter of the vessel, the anatomically free length, and the limb position. Before suturing, try to pull the two ends together to understand the suture tension, too much or too little tension and twisting will affect the anastomosis effect.

Although Fang Ziye can't operate, it doesn't mean that he doesn't know some small doorways for small blood vessel sutures at all-

Theories are not learned in vain.

It is especially important to ensure proper tension, as high tension can make it difficult to turn the vessel, which can affect the operation, and the anastomosis is prone to tearing and thrombus.

Fang Ziye then completed the operation of using a needle to break one end of the blood vessel, and steadily pierced the broken end of the blood vessel.

After this, Yang Wenzheng hummed softly, it is not surprising that this completed the first injection, which proves that Fang Ziye's ability is not bad, and it may be close to the level of a doctoral student.

Yang Wenzheng made a temporary decision, and while helping Fang Ziye fix the proximal end and lift the skin, it was convenient for Fang Ziye to operate, and at the same time, he said:

"In the process of microvascular repair, it is necessary to emphasize that it must be stable, accurate, light and delicate, and let students remember that improper operation of one needle and one thread will cause adverse consequences and even lead to surgical failure. The suture of each needle should be accurate, and the needle distance and margin should be uniform and consistent, so as to avoid repeated acupuncture and increase the damage of the blood vessel wall. When anatomically separating blood vessels and suturing and tying knots, it is necessary to emphasize agility, briskness, and dexterity, without excessive pulling, pinching, and squeezing of blood vessels, so as to avoid clumsy and unnecessary repetition, as well as uncomfortable movements. ”

"Pull open the stump at the proximal end of the vessel, and thread the stitch through it to complete the knot!" After Yang Wenzheng was fixed, he continued to drip heparin saline into the surgical field to flush the residual blood stains.

When Fang Ziye heard this, he also passed through the broken end of the blood vessel at a point, and completed the first stitch with a little jerky.

Decent, at least one knot is buckled!

"It's not bad, you're at the same level, at least it's okay to stitch tofu, right? The operation is quite stable. Yang Wenzheng asked.

"Brother Zheng, almost!" Fang Ziye nodded slightly, waiting for Yang Wenzheng to cut the thread.

"The end of the tail suture is an end-to-end suture method. This suture is suitable for suturing between the broken ends of blood vessels equivalent to the oral meridian, which can maintain the maximum flow rate and flow of blood, and is the most commonly used method of microvascular anastomosis. ”

"Generally speaking, the commonly used sequence of suturing the broken end of a blood vessel is the 3-9-point fixed-point method or the 12-6-6-point two-point method, and the 2-6-10 point three-point suture method, as well as the equidistant four-point suture anterior wall method, the first suture posterior wall method, and the winding suture method."

"Now you're suturing the front wall, and you're suturing the back wall, similar to the two-point positioning from 12 o'clock to 6 o'clock."

Yang Wenzheng pointed slightly.

Fang Ziye nodded hurriedly, and then with the experience of stitching the previous stitch, Fang Ziye stitched another stitch and stitched the back wall together.

There is a good look, and the two stitches have been completed, but Fang Ziye feels that he is more handy and a little happy, but he also knows that this is only the most basic suture, and it does not mean that the quality of the sutures is very high.

Yang Wenzheng's sutures in all segments were successful, but the blood vessel passage rate was still only more than 70 percent.

After that, the third and fourth stitches are completed, which is about 3-9 o'clock.

The blood vessels are thin and can only accommodate four stitches.

Pulling, needle in, needle out, suturing, knotting, thread cutting.

Yang Wenzheng continued to drip heparin saline, and kept nodding: "Ziye, you are really talented, I think about it now, you seem to be the only master in our orthopedic department who has cleared the practice room, right?" ”

"Alas, it's a pity that you are a student of Viagra, otherwise, you are definitely a very good seedling of hand surgery."

Yang Wenzheng was a little regretful.

Fang Ziye did the first time he sutured the broken tail blood vessel, and he could find the right points of the suture and complete the suture, which was already quite difficult.

Then, right away, Fang Ziye completed the fourth stitch, the suture at the nine o'clock position.

Yang Wenzheng also finished cutting the thread.

He looked at Fang Ziye with a smile, and asked with a little temptation: "How do you feel?" Looking forward to your vascular patency level? ”

Fang Ziye was a little nervous, his shoulders shrugged slightly, and after his heart was slightly raised, he looked at Yang Wenzheng's eyes and said, "Brother Zheng, why don't you give me a good time, the doctor and senior brother of general hand surgery, how many are the first time you complete the suture?" ”

Yang Wenzheng's right hand has been placed on the hemostat, if once released to let the blood unobstructed, then the instant blood flow detector can detect the level of vascular patency.

He smiled and said, "The first time for a doctor of hand surgery, there is a saying after the break, which is too big. ”

"One shot leaks!"

After speaking, Yang Wenzheng seemed to confirm this reality to Fang Ziye, and then opened the vascular clamp.

Let Fang Ziye see for himself how it leaked.

However, there was no movement after a second.

Two seconds later, the end of the blood vessel was broken, and there was still no sign of blood bursting out.

Three seconds later, the vascular instant meter sounded, and the data displayed on it was 81%, which was higher than the patency rate of the blood vessels he had stitched up before!

Fang Ziye didn't know what the situation was, his eyes were staring at Yang Wenzheng tightly, his eyes were innocent, and his expression was calm, like a curious baby, waiting to answer his questions.

Yang Wenzheng's eyeballs almost popped out, he looked at it a few times in disbelief, and patted the vascular instant measuring instrument again while wearing gloves.

A few seconds later.

Didi Didi sounded again, and it was still 80 percent, which was not much different from 81 percent.

Fang Ziye knew in an instant that if there was no accident, it might be an accident, and such an accident was in line with a guess he had made before.

Yang Wenzheng was a little flustered in an instant, and he didn't believe in evil.

The vascular clamp clicked and clamped it shut again, and personally cut a section of blood vessel for Fang Ziye.

"Come on, come on, you'll do it again?"

"?" This time, Yang Wenzheng looked at Fang Ziye's operation with his eyes.

And when Fang Ziye operated this time, his hand seemed to be more stable than before.

Still choose the most modest vascular end suture, the two-point positioning method from 12 o'clock to 6 o'clock, and then the suture at 3 o'clock and 9 o'clock.

Four stitches, after the stitches are completed in an orderly manner.

Yang Wenzheng nodded and said, "If you don't leak it this time, you kid will send it, you know?" ”

Fang Ziye didn't know much at the time.

But when Yang Wenzheng continued to let go of the vascular clamp that clamped the blood vessels, a super green number popped up after a few clicks from the vascular measuring instrument.

Vascular patency rate - 92%!

At this moment, Yang Wenzheng's eyeballs bulged out, his body bowed forward slightly, and he hurriedly threw away his gloves, still remembering that the gloves were very dirty in a hurry.

Then he clenched his hands into fists and rubbed his eyes with the soft flesh at the tiger's mouth.

After clearing the sight, I pinched the fold of the glove and pressed the vascular instant meter again.

The patency rate of the blood vessels measured again is 91%!

Yang Wenzheng stood up at that time.

"Don't move, sit here and don't move, I'll be right back!"

Yang Wenzheng retreated and said, "Don't move." ”

Fang Zi said in his heart, are you trying to take advantage of me? But seeing Yang Wenzheng's face changing suddenly at this moment, and his hurried figure, he didn't dare to move much.

Yang Wenzheng ran out of the practice room and shouted loudly: "Professor Wen, Professor Wen, master, master, master......"

Fang Ziye was a little unstable at that time.

And so it was!

(End of chapter)