This procedure is of an open carpal tunnel release surgery on the right hand. The steps to the surgery are in the text. I chose to elaborate on the hand markings to show where the underlying anatomy is. The surgeon thoroughly went over this to the resident and stressed its importance. I rendered this piece in line with Corel Painter. I love this program because I can really get the strokes how I want them to be, instead of relying on stroke presets in other programs.
I always love your work!