Chinese medicine: When you do things to the extreme

Chapter 79: Standing at the helm in times of crisis! (Subscribe)
Zhou Yanqing once again rushed to Emergency Operating Room 7 at a rapid sprint speed.

Among the 7 operating rooms, only Liu Wanqing and Ning Zhu were left.

Zhou Yanqing washed his hands and went straight into the operating room. After entering, he started putting on sterile surgical gown and then put on sterile gloves and approached the operating table.

"How is Teacher Huang's hand?" Zhou Yanqing asked in a low voice.

Ning Zhu was very patiently cleaning the wound on the broken limb and had no time to respond.

Liu Wanqing raised his head slightly, his eyelids still focused on his vision, and said, "Brother Zhu doesn't have time to look. A new operating room has been opened in the emergency operating room. Professor Tan Zhongyu and Professor Du Zhonghua both stepped down to perform the surgery!"

"Teacher Huang is too tired!"

"Attractor." Ning Zhu gave the order attentively.

Zhou Yanqing quickly handed over the negative pressure suction device——

The reason why I received Ning Zhu's call just now was that Huang Xianming stabbed himself directly in the back of his middle finger while performing a debridement operation on the operating table, perhaps because he was too tired or had muscle contracture!

The operating table was contaminated at that time. After being disinfected and covered with a drape, Ning Zhu took over and continued the operation.

After Ning Zhu took the negative pressure suction device handed over by Zhou Yanqing, he looked up and said, "Yanqing, you have to help me complete the vascular suture for the replantation of the severed finger later!"

"The diameter of the blood vessels in the upper arm is larger than that of the digital arteries, so the operation will be relatively simpler."

"After we fix the broken bones and suture the blood vessels, Professor Tan will come to perform the nerve suture." Ning Zhu did not discuss with Zhou Yanqing, but gave the order directly.

"Okay!~"

"Brother Zhu, Teacher Huang was injured. Could it be that he was distracted because I called the roving teacher over to ask questions?" Zhou Yanqing asked with a nervous heart.

A surgeon's hands are the soul of this profession, and the hands of a hand surgeon are especially important.

Before this, Zhou Yanqing asked the touring teacher to ask for instructions on his behalf twice!
If Huang Xianming was injured because of his request, Zhou Yanqing would feel guilty even if he was not responsible.

As a junior doctor, it is normal to ask for instructions from senior doctors. The capital of youth lies in the fact that the main job is learning.

If someone could do everything and be omniscient and omnipotent, then there would be no such thing as doctors of different ranks in this world.

Ning Zhu shook his head: "No, I personally feel that it is because I was too tired. After moving my fingers too many times, it caused local muscle spasms, so I deviated from the direction during the operation."

"Professor Huang's question is not the focus of our discussion now. Our mission is to complete this operation with high quality!"

In the group, there were few people who could routinely complete vascular suturing. Apart from Professor Tan Zhongyu, only Professor Huang Xianming had the highest level of vascular suturing.

After Huang Xianming was injured, short and medium-sized players like Ning Zhu and Zhou Yanqing had to step up.

……

Of course, for the next operation, Zhou Yanqing does not need to be in charge of the thinking, he just needs to follow Ning Zhu's operating ideas.

It was a very standard limb replantation operation.

Thorough debridement, fracture fixation, vascular suture, nerve suture and tendon suture are the principles of severed finger replantation.

The stump of the severed limb is relatively flat.

It was said that the injured person was a carpenter. Due to carelessness, his right arm was cut off by a saw when he turned around, so he was sent to the hospital immediately.

Although he did not need to be in control of his own thinking, after the "panic" experience of the previous operation, Zhou Yanqing began to read and interpret Ning Zhu's thinking during the operation.

When replanting a severed finger, the general principle is to clean the wound first and then reattach the limb.

However, each specific step of the operation may be greatly modified when it comes to a specific case due to different locations and injuries.

After humeral disarticulation, the first choice is plate and screw fixation.

The fracture ends of this patient were relatively regular, and Ning Zhu did not have any complications. He only shortened the fracture stump by 2 cm before replantation of the broken limb.

Seeing this, Zhou Yanqing asked at the right time: "Brother Zhu, the book suggests that if you plan to perform a vascular transplant, you almost don't need to shorten the bones, right?"

Zhou Yanqing's current theoretical knowledge is miscellaneous but not profound. He knows a little bit about everything, but he has no unique experience of his own.

Theory at the specialized level means that one has a broad understanding of the theory. It is impossible to come up with original insights, so one has to experience and learn slowly!
"Yes, if you want to do a vascular transplant, you can avoid shortening."

“But we have to race against time now.”

"Professor Huang is definitely unable to perform the operation. There is a sudden influx of patients and our department's current manpower reserves are still insufficient. Therefore, we must end this operation as soon as possible to avoid ischemic necrosis!" Ning Zhu made the decision very decisively.

As the chief surgeon, being decisive and efficient is a must.

Zhou Yanqing didn't say any more. While Ning Zhu was fixing the humerus, Zhou Yanqing helped to clamp the broken limb, while Liu Wanqing and Ning Zhu started the internal fixation procedure.

Internal fixation is simple in principle, but not easy to perform.

In fact, fracture open reduction and internal fixation is a trauma surgery procedure. However, hand surgeons must also be able to perform finger replantation surgery! If pedicled bone flap transplantation is involved, hand surgeons also need to perform internal fixation.

Hand surgery is a subspecialty separated from trauma surgery, and they share the same origin.

After Senior Brother Liu Wanqing and Ning Zhu worked together to complete the internal fixation operation, they came to the very important steps such as soft tissue suturing.

Ning Zhu began to assign tasks. After handing over a portion of the blood vessel suture to Zhou Yanqing, Liu Wanqing called another person to the stage. The four of them worked in pairs, slowly advancing the surgical process...

Just when Zhou Yanqing and Ning Zhu had finished suturing the blood vessels and released the vascular clamp to clear the blood flow, the automatic sensor door of the pneumatic operating room was stepped open.

Outside the door, Professor Tan Zhongyu walked in while adjusting his hat, and said in a serious tone: "Ning Zhu, how is the current progress of this operation?"

In order to save time, Professor Tan Zhongyu started tiptoeing halfway through the operation to watch the progress of the operation.

Ning Zhu looked up when he heard this: "Teacher Tan, with Yan Qing's help, we rebuilt the vascular network in just over 40 minutes, and the blood flow is currently good!"

As he spoke, Ning Zhu pinched the wound on his finger and found blood slowly seeping out.

Moreover, there was no blood oozing from the surgical stump.

This means that the patient's current blood supply system has been rebuilt and has a good patency rate. If there are no special circumstances, such as postoperative blood vessel swelling leading to local vascular necrosis, infection, etc., the chances of the severed limb surviving are very high!
Tan Zhongyu slowly breathed a sigh of relief: "Very good, thank you for your hard work."

"After the blood vessels are sutured, you will start by suturing the muscles and tendons. You must rebuild the soft tissue space of the upper arm."

"After you've dealt with all of this, give me a call and I'll come over to deal with the nerves."

Tan Zhongyu walked out halfway through his speech.

I think the operation in the operating room he left before also needs to be completed. There is only Liu Qingshan in charge, and his comprehensive ability is not as good as that of the perverted chief resident Ning Zhu.

Therefore, Tan Zhongyu had no choice but to leave the operating room where Ning Zhu was and go to the next room to provide backup.

"Okay, Professor Tan." When Ning Zhu replied, Tan Zhongyu had already left.

At critical moments, the pace would quicken and I wouldn't even want to say a word. There was no such relaxed feeling of strolling in the garden or taking one step at a time as during elective surgery.

As the blood circulation improves, we can see that the white and locally purple areas of the patient's affected limbs gradually return to flesh color as the blood circulation improves.

Ning Zhu shouted, "Anesthesiologist, please pay attention to reperfusion injury. Our next surgery will take quite a while..."

"Okay." Upon hearing this, the anesthesiologist stood up and adjusted some button. At the same time, he instructed his assistant to start drawing electrolytes for an emergency check.

Compared with tendon suture, muscle suture has relatively lower suture requirements, but not too low.

Ning Zhu gave Liu Wanqing a chance to sew, but soon took over the main operation position in his own hands. After looking at Zhou Yanqing's sew quality, he let Zhou Yanqing and him operate bilaterally with confidence!
……

When Professor Tan Zhongyu returned to the operating room to start nerve suturing, Tan Zhongyu said that the operation in the next operating room had been completed.

Ning Zhu then asked, "Professor Tan, did Brother Xianming have any nerve or blood vessel injuries? I took a rough look and it seems that he only has an extensor tendon injury."

"The tendon sheath was also damaged, but it has been treated."

"For the later functional recovery, we can only look at the rehabilitation effect. It should be okay, but the strength will definitely decrease a lot!~" Tan Zhongyu's brows were much gloomier.

A surgeon's hands look no different than those of an average person.

However, if the flexibility of any of the ten fingers is damaged, it will have a significant impact on the overall strength.

After Huang Xianming's strength is downgraded, it is obvious that the team's overall ability will also decline.

Unless Tan Zhongyu works overtime and has more energy, or someone else among the junior doctors can take over Huang Xianming's position.

Both of these seemingly feasible alternatives are a bit far-fetched.

While suturing the perineurium, Tan Zhongyu suddenly looked up at Zhou Yanqing, then shook his head: "Don't feel pressured, our group will remain the same as it was before."

"If we don't have enough physical strength, we will perform fewer elective surgeries and delay surgical turnover."

"Even in ancient times, when they were fighting a war, they still needed to rest and recuperate. What's more, we are just a departmental team in a hospital?"

Ning Zhu nodded and said, "Professor Tan, I have often heard you say that our department is too short of staff, but I have always found it difficult to fully understand your words."

"But today, when Brother Xianming suddenly got injured, I was really panicked. I was so afraid that this operation would end like this..."

What is the worst outcome after the surgeon is injured? Failure of replantation of the severed finger.

The patient had no place to seek justice, and Ning Zhu had no place to seek justice either.

Tan Zhongyu went on to say: "People who are able to remain calm and composed when given a mission in times of crisis are all capable of great use."

"Lack of people is the norm. I wish there were a hundred experts in the team, ready to take orders at any time, but the growth cycle and curvature are here, which cannot be controlled by human power. It is better to have less than too many people..."

(End of this chapter)