Start From Emergency Doctor

Chapter 235

Under the microscope, the structure of blood vessels is very clear.

Except for infection and swelling at both ends of the great saphenous vein, the whole blood vessel seems to be fine…

But soon, Zhou Yuan’s eyes lit up.

“Director, take a closer look at this blood vessel.” Zhou Yuan dialed the saphenous vein.

The director of vascular surgery watched for a long time and didn’t see any problems.

“Wait, you can see it by comparing it with the blood vessels on the patient’s arm.”

Zhou Yuan said, putting the great saphenous vein and the patient’s own radial artery together.

The director of vascular surgery watched for a few seconds, his expression became more and more surprised, and said: “The saphenous vein has become thinner…”

“Yes, compared with the radial artery next to the great saphenous vein, the wall of the blood vessel is thinner because it has been stretched!”

“Stretched?!”

Both vascular surgeons stared.

Zhou Yuan recalled all kinds of knowledge about vascular transplantation in his mind, and quickly found the answer, explaining:

“The reason why the saphenous vein I chose before is longer than the required length is because I soaked the saphenous vein in heparin saline, which would cause the saphenous vein to retract. In other words, I took the saphenous vein. After retraction of the great saphenous vein, the length is actually the same as the length I need.”

“Then why has it become longer this time? No matter how you explain it, if my transplanted blood vessel is retracted, it can only be shorter. How can it become longer?”

Zhou Yuan smiled and said, “This is the crux of the problem. At that time, I had an anastomosis of a vein, the blood flow in the vein was smooth, and the lumen was relatively large, so I basically did not change the length of the transplanted blood vessel. And now you have an artery …”

“Due to the high pressure of the artery, after the blood flow is restored, the vein will stretch to a certain length under the influence of the pressure of the artery. The pressure of the radial artery can stretch the great saphenous vein by about 10%…”

The director of vascular surgery was stunned.

The doctor who was in charge of the surgery before was also sluggish.

“I…I’m not, it’s never happened before!”

“Because you didn’t use heparin saline for soaking, right?” Zhou Yuan looked at the surgeon who had failed the operation.

The failure chief nodded blankly, with astonishment on his face, “How do you know…”

“I guess, you accidentally cut it to the required length when you cut it… Under normal circumstances, the saphenous vein we need to cut should be longer than the original, and then it is soaked and retracted in heparin saline. We need the length to prevent blood clotting and protect blood vessels.”

“The length you should take should be longer than the original length, and the blood vessel can be transplanted after retraction, but the actual length is missing, so you skip the retraction step…”

The failed surgeon was too shocked to add: “Yes…I speeded up the operation, thinking about making up for the effect of not being able to preserve the blood vessels with heparin saline…”(Read more @ wuxiax.com)

Zhou Yuan nodded and said, “That’s the problem here. Heparin saline also has a role in preventing vasospasm! Your blood vessels have not been soaked in heparin saline, so accidentally spasm occurs, causing blood flow resistance to increase, which makes blood flow to the blood vessels. The increased pressure caused the blood vessels to be elongated…”

“It turned out to be like this…” The failed chief knife stared at Zhou Yuan in a daze.

No wonder the operation will fail…

“Um, doctors, you have been discussing for two minutes, I haven’t had general anesthesia…” The patient suddenly spoke.

Zhou Yuan recovered and continued the operation, comforting: “It will not affect, it is just a minor operation.”

The patient breathed a sigh of relief.

“I heard you say a lot, although I don’t know what you are talking about, but…I feel like you are amazing.” The patient was a little happy.

He was naturally relieved to be able to let a powerful doctor operate on himself.

“Artificial blood vessel.”

Although autologous blood vessel transplantation is more advocated, artificial blood vessels have certain advantages since they exist.

For example, it is suitable for the current situation.

On the other hand, artificial blood vessels have stable physical and chemical properties, suitable mesh size, and certain strength, and are easier to suture than blood vessels during implantation operations, and blood oozing is less than human blood vessels when the blood vessels are connected and let out.

After the artificial blood vessel was processed, the director of vascular surgery anastomosed the artificial blood vessel with the radial artery, and Zhou Yuan began to suture it.

Zhou Yuan glanced at the failed chief, and found that the latter was very depressed.

“Anyone will fail, and the patient is not in danger of life. You can just pay attention to it later.” Zhou Yuan comforted.

The Director of Vascular Surgery sternly scolded: “Next time you don’t want to reduce the steps privately! Each step is the best result from the experience of the predecessors, and every step of the exploration may kill countless people! Just follow the prescribed steps!”

The patient shivered: “Don’t use me to explore the steps…”

Zhou Yuan sutured the distal end of the artificial blood vessel with the proximal end of the artery, and the proximal end was sutured with the distal end of the artery, and at the same time, he cleaned the infected area next to him.

The anastomosis of the artificial blood vessel is much simpler than that of the human blood vessel. Zhou Yuan, who has no pressure to suture the human blood vessel, can handle the artificial blood vessel as easily as a joke.

After the suture was completed, Zhou Yuan picked up the tweezers and gently pulled the suture to tighten the suture.

Next, tie the knot and complete the final stitching.

Zhou Yuan started to deal with the surrounding blood vessels again.

After completing the second blood vessel transplantation of the radial artery, the surroundings were all small problems. After more than ten minutes, the blood vessels in the arm returned to their original positions and everything returned to normal.

Zhou Yuan breathed a sigh of relief and said, “Restore blood supply.”

The director of vascular surgery removed the vascular clamp, and the blood from the radial artery immediately poured into the artificial blood vessel, and irrigated the entire palm along the vascular network, and finally returned to the heart…

Everything at the vascular anastomosis is as usual, there is no oozing phenomenon, and the blood circulation is unobstructed!

Zhou Yuan added: “Put more anticoagulant drugs after surgery.”

Generally speaking, anticoagulant drugs are not required after vascular transplantation, but patients have precedents of vasospasm and infection, and anticoagulant drugs must be given to prevent recurrence.

Next, Zhou Yuan began to suture the arm skin.

Soon after, Zhou Yuan put down the needle holder, looked at the time, and said, “The operation is complete.”

The patient and Zhou Yuan and others breathed a sigh of relief at the same time.

Zhou Yuan took off his mask and walked out of the operating room with the vascular surgery doctors.

Soon, the patient was also pushed out of the operating room and sent to the ward.

Before Zhou Yuan could return to the vascular surgery hall, the little nurse who was swiping his mobile phone suddenly screamed.

“Doctor Zhou! Come see Doctor Zhou!”

The little nurse ran over excitedly and slid her phone to show Zhou Yuan. .