Ulinastatin 100 units were pumped before anesthesia induction, and dexmedetomidine 0.5ug/kg was given within 10 minutes.

Induction administration of midazolam 2 mg, sufentanil 40 μg, etomidate 10 mg, rocuronium bromide 50 mg.

Ren Haitao pondered every step many times, although it was the most common anesthesia induction, he still tried his best to be flawless.

Anesthesia is induced and the endotracheal intubation is followed by 3 minutes.

There was no problem with the patient's oropharynx, and the prepared bronchoscope was not used. Connect the ventilator, expose the head operation area, and leave it to Chu Zhixi.

Sufentanil 20 ug was added before the start of the operation, and propofol 4-8 mg/kg/h and remifentanil 0.1-0.3 ug/kg/min were used for intraoperative anesthesia, and rocuronium bromide was added intermittently.

After everything is done, Mr. Wu Mian Wu has already started the scab cutting operation, and Ren Haitao can have the leisure to watch the operation at this time.

After more than 10 days of growth on the affected side of the injured person, blood crust scar tissue has formed at the burned site. The black, dark red scabs looked as hideous as strange armor.

The electric skin extractor buzzed, and the hard blood scab was thinned little by little. Wu Mian's movements were very fine, the blood scabs on his upper limbs were cut off very evenly, and Director Li of the Burn Department, who was holding sterile gauze next to him, was ready to press gauze to stop bleeding at any time.

However, the blood scab under the electric paring knife thins at a visible rate, and even appears depressed, which is lower than the position of the surrounding skin tissue, forming a depression, and there is still no bleeding.

"Mr. Wu, how did you achieve such an even scab cutting operation?" asked Director Li.

"Feel the hand. Wu Mian said softly.

The blood scab is right in front of you, but no one knows how thick the blood scab really is. Generally, the surgery is only shaved and the bleeding is compressed.

Some patients with extensive burns may have hemorrhagic shock during surgery, which is a normal complication.

It can be seen that Mr. Wu Mian's movements are gentle and delicate, the electric paring knife is really scabbing, 5 minutes after opening the stage, there is no trace of bleeding, Director Li even has a doubt that Mr. Wu will cut the blood scab into transparent.

Thin as a cicada's wings is just a description, but Director Li really thinks that it may become a reality.

"Although the damaged area is about 17.2%, the damage is as small as possible, and the recovery after surgery can be faster. Wu Mian said.

It's easy to say, but it's hard to do.

"Girl, let's go. ”

Finally, at 6′22", Wu Mian asked Chu Zhixi to start surgery to remove the skin.

It's early, Director Li is a little puzzled. Generally speaking, the scab is cut first to stop some of the bleeding and try to preserve useful blood vessels. Even if it is a microsurgery, a small arteriovenous anastomosis must be scabbed first.

However, he did not question Mr. Wu, but watched quietly.

Finally, a hint of bright red mixed with pale yellow exudate appeared in the field.

Director Li had a place to use, and the sterile gauze in his hand was pressed against the wound, with moderate strength, and it did not affect Wu Mian's technique.

When the first piece of scalp was delivered, the blood scab had just been peeled off, and it was only perfect in terms of time.

"Vascular blocking forceps. Wu Mian stretched out his hand, and a small and delicate pliers slapped into his hand.

The electric paring knife buzzed for the last time, and then the field turned bright red.

Wu Mian put the electric paring knife aside, held sterile gauze in one hand, and held vascular blocking forceps in the other, dipped it in blood, and the small forceps directly reached in, closed, and clamped.

Director Li didn't even see what was going on, and the action was already over. However, he was not stunned, and hurriedly held on to the vascular blocking forceps.

Wu Mian picked up the scalp handed over by Chu Zhixi, which is rich in capillaries under the scalp, which is conducive to re-establishing blood circulation and allowing the skin after skin grafting to grow well.

Director Li only glanced at his scalp, and his eyes straightened.

The capillary arteriovenous dissection is clean and clean, leaving on the scalp like thinning hair. At this time, Director Li regretted a little, he should have watched Professor Chu Zhixi Chu's scalp free.

Mr. Wu is an operator, and watch him do surgery. But just seeing the scab, there is really nothing to see.

I regretted it in my heart, but as soon as the operation began, there was still a chance, Director Li moved a few centimeters slightly towards Chu Zhixi's side, and his movements were slight, trying not to let Teacher Wu see that his attention was elsewhere.

But at this time, the scissors in the microscope equipment in Wu Mian's hand were lightly clicked and picked, and there was almost no movement.

This is...... Peeling off the adventitia of the blood vessels?

Director Li was stunned.

Generally, you should use vascular forceps to clamp the adventitia of the broken end of the blood vessel and pull it outward and cut it off, so as to avoid bringing the adventitia into the lumen during suturing and causing thrombosis.

Or use small scissors to carefully peel off and cut off the adventitia of the severed end of the blood vessel, and carefully damage the blood vessel wall along the way.

This step depends on the level of the surgeon, and the length of time varies, but as long as the level is sufficient, the adventitia will be carefully cut, and it is best not to omit.

What did Mr. Wu do?

Director Li felt a sense of remorse in his heart, what did he think, why did he go to see the skin of the donor peeled off, he should have been watching Mr. Wu's surgery.

He felt that his face was slapped by the left and the right, and it hurt.

Sure enough, it was to peel off the adventitia of the blood vessels, and Director Li was not mistaken.

The scissors in Wu Mian's hand then picked up the translucent adventitia of the blood vessel as thin as a cicada's wings, rubbed it on a piece of gauze at hand, and the scissors returned to the instrument nurse and asked for 0.1% heparin saline to start flushing the blood vessels.

"Caplon line, 11-0. Wu Mian said softly.

Then Wu Mian pulled the vascular clips at both ends of the blood vessel closer, so that the opposite end of the blood vessel was brought closer, and a certain point was sutured at the upper and lower ends.

Two needles are ligated on the outside of the vessel at the same time.

The two-point intermittent seam is legal! Mr. Wu actually chose the most difficult two-point intermittent seam to operate!

There are many advantages to this method of suturing, but the disadvantages are also obvious - the difficulty of suturing is huge.

Director Li cheered up and watched Wu Mian tie the knot with all his attention. During the ligation, Director Li clearly felt that Wu Mian's strength was gentle and stable. This is the capillaries, and with a little bit of force, the blood vessel wall will tear.

Sometimes I have to do surgery on my own, and I have to start all over again.

If it's a donor...... Anyway, cut it short and do it again. If the blood vessels under the blood crust are torn, it will be a headache. This has always been an extremely difficult point for microanastomosis, but Mr. Wu gently and gently tied a knot to end this operation.

After the anterior wall is completed, the blood vessel clamps at both ends are flipped upward, and the back wall of the blood vessel is sutured according to the upper method.

Every step was done with a clear eye, Director Li did not wear a microscope, he could only judge from Wu Mian's movements which step the operation had reached.

The strange thing is that the two-point intermittent suture legally requires an assistant to help lift the thread, and Mr. Wu did not throw the thread over. Director Li made a note of this and prepared to ask if there was any new anastomosis after surgery.

The operation progressed steadily step by step, and suddenly the alarm of the monitor sounded loudly.

The shrill sound of an alarm gets the adrenaline pumping.