This doctor is already middle-aged, and he's only just started practicing medicine.

Chapter 117 Fasting Balance! ~ (44)

"Currently, the mainstream nerve suturing is simply nerve suturing, without any special techniques; it is merely the application of interrupted suturing in nerve ruptures."

"Currently, there are three main suturing concepts: outer membrane suturing, peritunic suturing, and combined peritunic and outer membrane suturing."

"This alliance is not the same as that alliance; it means operating independently."

"Another modified suture technique involves grouping 3-5 small bundles together to reduce the number of suture stitches..."

The anatomical structure of a nerve is very similar to that of an electrical wire, with an outer membrane and many nerve bundles inside.

However, these nerve bundles are not divided into live and neutral wires, but rather into sensory branches, motor branches, etc.

"However, the success rate of nerve peritunic and epitunic suturing is also limited, and each has its own drawbacks."

“根据尺神经损伤缝合术后12月的数据，束膜缝合的优良率大概有81.0%-88%，外膜缝合的优良率仅32.5%-47.4%！”

"This high success rate used to meet clinical needs, but in today's highly developed hand surgery field, it has become a limitation."

"Of course, epidermal suture does not carry the risk of ischemia between nerve bundles, while peritunic suture has an ischemia rate of about 15%."

"Based on this, our hand surgery department has been continuously improving the techniques of nerve suturing, striving to combine the advantages and disadvantages of the peritunic and the adventitia..."

"Currently, although a formal technique has not yet been developed, the overall data is still higher than that of mainstream suturing methods, and this suturing technique will make your clinical work smoother..."

"I have already taught you the specific suturing method, and it is not difficult. The rest is up to you to practice."

After giving a practical demonstration lesson, Professor Liu Huanglong really just took a quick tour and gave guidance to everyone.

The first stop was in front of Dong Qiaoshan, who nodded repeatedly: "Your basic suturing skills are good, and the details of your operation are also very specific. The suturing of the perineurium of the nerve will be based on simple suturing, with slight modifications. What you need to pay attention to is the angle of needle insertion and withdrawal..."

"Furthermore, when performing perithelial separation, do not overdo it. Excessive separation of the perithelial membrane is the root cause of perithelial ischemia and necrosis."

"Thank you, Teacher Liu." Dong Qiaoshan nodded earnestly and continued working meticulously.

Liu Huanglong then walked over to Xie Yuan'an, looked at her through the glasses in the assistant's seat for a while, and then scolded her: "Steady your hand! Shaking it like that, even the aunties serving food in the cafeteria don't have Parkinson's disease like you."

"Why are you blinking like that? Are you trying to tell your neurotic you're cute? Are you trying to melt the baby neuronal cells with cuteness?" Liu Huanglong immediately launched into a scathing attack.

Xie Yuan'an sat up straight, her face showing no sign of grievance, but she was completely focused on the operation she was doing.

Liu Huanglong watched for a while, then stood up and said, "Practice slowly. You haven't even crossed the threshold of the most basic and essential requirements for hand surgery suturing."

"Hands don't shake, blinking is controlled, tears haven't been shed enough!"

Lin Bin, Ding Mengzhuo, Liu Qiming, Han Gongqiang and others also received Liu Huanglong's personal guidance, but Liu Huanglong's tone was not as fierce as it was towards Xie Yuan'an; on the contrary, he was very patient.

Liu Huanglong then went to Lu Cheng's assistant's position under the eyepiece, his voice quite impolite, yet full of knowledge: "Don't act on your own. Don't bring tendon suturing techniques into nerve suturing."

"Tendon suturing aims for suture toughness, while nerve suturing aims for tension-free sutures, requiring precise alignment of the nerve ends."

"Yes, that's right. Don't bring other suturing techniques into nerve suturing. Just the simplest and most basic interrupted suturing."

"When performing nerve suturing based on the principles and concepts of tension-reducing suturing, if the nerve is squeezed too much, it can easily lead to neuroma, causing the healed ends to swell and causing more pain to the patient..."

"Hmm?" As Liu Huanglong spoke, Lu Cheng actually made very detailed corrections to his suturing technique. "What's your name?" Liu Huanglong looked up at Lu Cheng.

Lu Cheng raised his head, revealing a neat hairline beneath his short hair. His skin was slightly dark, but he exuded a sunny disposition, and his eyes were bright and piercing.

He looks like he could make a living off his looks, but he's also incredibly skilled in martial arts. He's probably around 27 or 28 years old, and has a baby face...

“Teacher Liu, my name is Lu Cheng, Lu as in land and Cheng as in success.” As Lu Cheng spoke, he also sized up Liu Huanglong.

With a long face, thick nose, small eyes, and short eyebrows, he could be described as shifty-eyed at first glance, and he must be someone who makes a living through his skills and talent.

“Sew it up again, let me take a look.” Liu Huanglong pointed to the operating table.

Lu Cheng listened and did as instructed, casually adding one more skill point to his already limited skill points.

In a short time, the shortcomings that Liu Huanglong had mentioned regarding Lu Cheng's application of tendon suturing techniques to nerve suturing were completely eliminated.

After watching for a while, Liu Huanglong even noticed that Lu Cheng's skill seemed to be slightly more refined than the last time he stitched.

Tension-free anastomosis and bundle (group) positioning matching are the cornerstones of nerve function recovery, and all nerve suturing is aimed at this goal.

Therefore, the key to nerve suturing technique lies in tension-free, gentle, and precise positioning and matching.

To achieve the above two points for a severed nerve, a lot of very specific work is required, such as the choice of the needle entry and exit points, the depth and width of the suture, and even the force of the knot, all of which will affect the final prognosis.

[Nerve suturing (Proficient 8/10)]

Liu Huanglong said, "Neural peritunic suturing must be performed under a 40x microscope (with a suturing error of less than 50μm). This is the basic requirement. To do it well, the suturing error must be controlled to within 20μm or even 5μm."

"Peritoneal sutures are often used for small nerve injuries and mixed nerve injuries, where nerve bundle separation is difficult. Therefore, perineurial sutures are an essential skill to learn..."

"In the suture of the nerve peritunic, the careful separation of the peritunic will also affect the final suturing. Therefore, what looks like a suturing is actually a complete manifestation of all the basic skills."

"Let me disassemble the fascia for you..."

[With expert guidance on the essentials of nerve suturing, my nerve suturing skills have slightly improved.]

[With expert guidance on the essentials of nerve suturing techniques, my skill level in perineural-epidermal suturing has slightly improved.]

A few minutes later, Liu Huanglong released the controls, allowing Lu Cheng to continue operating.

Lu Cheng calmly continued the suturing procedure, and in the operating room, he even seemed to have developed a photographic memory for copying.

"Yo-ho!" Liu Huanglong's small eyes lit up, and he made a strange sound.

……

Then they never touched Lu Cheng again.

Xie Yuan'an, Dong Qiaoshan, and others glanced at Liu Huanglong occasionally and found that he was completely absorbed in his experience as a teacher who was 'effective in teaching', and had no idea that there were other students who needed care...

Now everyone's at peace.

Fasting balance!
(End of this chapter)