Chapter 66: Replantation of severed finger - "In the beginning of the 1970s, I made a fortune by buying goods for zero yuan"

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Wang Jianxin started surgery.

The first step is debridement.

He rinsed the wound repeatedly with povidone iodine and normal saline, over and over again, to flush out all the iron filings, oil, bone fragments and debris from the wound.A nurse next to him was cooperating and handing him various tools, including pliers, tweezers, scissors, whatever he wanted.When removing the contaminated soft tissue, he was very precise, cutting off the necrotic parts and leaving the good ones behind, no more but no more.Use rongeurs to trim the broken end of the bone so that the section is flat and smooth, like a plank pushed through by a plane.

This is the basis for replantation of severed fingers.If the debridement is not complete, infection will inevitably occur after the operation, and the fingers will rot and the grafts will become white.The trimming is not precise, the bones heal poorly and grow crookedly. From now on, this finger will just be a decoration.

Wang Jianxin's hand is very steady, and every stroke of the knife is measured.The nurse next to him didn't dare to blink while watching his operation.

The second step is to fix the bones.

He inserted a Kirschner wire from the broken end to fix the bone in position.A Kirschner wire is a slender steel needle, a little thicker than a sewing needle, that passes through the medullary cavity and strings together broken bones.Wang Jianxin's fingers were surprisingly steady. He aimed the needle tip at the bone marrow cavity and pushed it in.The spiritual exploration allowed him to feel the resistance of every bone. He knew exactly where the needle went and what it encountered.

The direction, depth, and angle of the Kirschner wire just avoid important blood vessel and nerve bundles.It's not luck, it's because he can "see" it.

The third step is to suture the blood vessels.

This is the real test.

Wang Jianxin leaned in front of the microscope, with his left eye closed and his right eye against the eyepiece.The lens of the old microscope was already a little blurry, but he adjusted it for a long time and found a fairly clear angle.He held a microforceps in his left hand and a microneedle holder in his right hand, and began to suture the digital artery, which was only 0.3 mm in diameter.

What is the concept of 0.3 mm?Not much thicker than a hair.It is not visible to the naked eye and can only be operated under a microscope.

He used his consciousness to observe both ends of the blood vessels and found them under the microscope at the same time.The walls of blood vessels are as thin as paper and can break with the slightest touch of a needle tip.He held them together with microscopic forceps and began to sew them together.

The thread used is 10-0 nylon - thinner than a human hair and almost invisible to the naked eye.Wang Jianxin's hand moved slowly under the microscope, and the needle tip passed through the blood vessel wall, one needle, two needles, three needles...

He sutured two arteries and three veins on his index finger.The middle finger was severely damaged, with the bone exposed and a piece of soft tissue missing. He sutured an artery and two veins.

Professor Qian stood nearby and watched without saying a word.His hands clenched unconsciously, and his knuckles turned white.

He has seen many replantation surgeries for severed fingers, including those at Union Medical College, Tongren, Shanghai, and Guangzhou.But none of them were made by worker, peasant, and soldier students, none of them were made under such a worn-out microscope, and none of them were so stable the first time they started using them.

The fourth step is to suture the nerve.

The nerves in the fingers are as thin as the blood vessels, but suturing is more demanding.The nerve bundles must be aligned, and there must be no mistakes, otherwise the feeling will not be restored after the operation - it is connected, it is flesh and blood, but there is no feeling when touching things, almost like a prosthetic limb.

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