noon.
Ling Ran, who was full of food and drink, sat on the chair in the office, opened Xiaoyao, half-lyed and looked out of the window, staring at the corner of the building in front of him, lost in thought.
The sun shines on the ground, warm.
On his left is a glass of lemon, kumquat and passion fruit tea from the nurse's station, with ice cubes added, misty and refreshing. On his right are three small snacks given by the patient's family members.
Although receiving red envelopes is no longer allowed, food feeding by patients and their family members is still allowed. It's just that most of the patients and their family members sent fruits or snacks to everyone in the department. This explanation, which is dedicated to a certain doctor, only came after Ling Ran came.
"Are you full?" Huo Congjun nodded in satisfaction when he saw Ling Ran recharging his energy when he returned to the office.
Ling Ran said "En", and asked, "Is the patient here?"
"Wang Haiyang is looking at the materials, but he hasn't made a decision yet." Huo Congjun asked, "Chocolate or something, did you buy it?"
"I bought a piece." Ling Ran showed a large piece of Dove chocolate, which he bought in a vending machine.
"Not enough." Huo Congjun shook his head when he saw it, and said, "The operation time for the replantation of severed fingers may be long, what if you are hungry by then?"
"I haven't heard of other doctors eating in the operating room..."
Huo Congjun curled his lips and said, "They are them. Our emergency department does not pass on the secrets, that is, drink well before the battle, take time to eat well during the battle, and eat well to replenish energy after the battle... Then who? , give Ling Ran two Snickers bars."
A small resident doctor delivered a Snickers bar.
Ling Ran had no choice but to put it away, and gave away a small snack.
Only then did Huo Congjun nod his head: "Let's go in and listen to Wang Haiyang first, Director Wang. He asked you to take over, and you can take over again. Although it's all microscopic surgery, replanting a severed finger is still different."
"Quack quack quack quack quack."
Ling Ran didn't speak, the chair next to him was shaking strangely.
Huo Congjun and Ling Ran looked over naturally, and saw Lu Wenbin sitting on the chair trembling, unable to stop even if he wanted to.
Embarrassed by the look, Lu Wenbin stood up abruptly, and said with a sneer, "I'm just a little excited."
He is the default candidate for the second assistant, and it is also the first time to participate in the replantation of severed fingers.
Huo Congjun said unhappily, "Why weren't you excited when you were called to rescue patients?"
Is this being jealous? Lu Wenbin said happily and nervously: "I'm excited too, more excited, but I didn't have time to shake at that time, I didn't realize..."
Huo Congjun said "En", and said to Ling Ran, "Don't go too far, go to the operating room at any time."
After thinking about it, Huo Congjun left the office.
Lu Wenbin's nervous legs trembled: "Did I say something wrong? What does Director Huo mean?"
He subconsciously looked at Ling Ran, only to see that Ling Ran was bathed in the sun, and his face was about to glow with holy light.
Instead, the fingers of his hands were moving rapidly.
Ling Ran was obviously simulating the process of suturing his severed fingers. Compared with tang method suture, the focus of suture of amputated finger is changed from tendon to blood vessel. The flexor tendons of the fingers are as thick as two or three rubber bands, and the blood vessels are usually within 0.5 mm, which is the thickness of the tip of a fountain pen. The difficulty of suturing is self-evident.
Small blood vessels can also cause problems with blood clots.
Thrombosis is an extremely dangerous existence, and it can be said to be a major factor in hospital death and disability. In order to prevent blood clots, during the nursing process after the amputated finger is sutured, the nurse will continue to cut the wound to use heparin.
The premise of using a heparin requires the stability of the surgeon's needle insertion.
Only sutured blood vessels, but not stable sutured blood vessels are not so obvious in other parts of the body, but it is absolutely not allowed in the replantation of severed fingers in hand surgery.
It can be said that the stable suture under the microscope is the biggest difficulty in the replantation of severed fingers. Yunyi Hand Surgery spends millions of yuan to set up a practice room, with an annual expenditure of one million yuan, just to train young doctors in suturing skills.
In other departments, everyone operates directly on the patient, who would like to play with the tail of the white mouse after get off work.
However, hand surgery does not do this, and the accident rate is so high that in recent years, hospitals have built their own practice rooms.
Lu Wenbin knew that Ling Ran had completed the graduation-level operations in the hand surgery practice room when he first started his internship, so he stared closely at Ling Ran's fingers, trying to figure out the key points of his operations.
Puller Man can do it without a brain, but Lu Wenbin wants to learn it with his brain.
look at...
look at...
Lu Wenbin fell asleep peacefully, the sun shining on his cheeks, it was refreshing and itchy.
"The patient is coming." Ling Ran's cell phone rang, it was Director Wang Haiyang's WeChat account.
Ling Ran opened his eyes abruptly, tore open the packaging of the chocolate, and ate a piece of chocolate in one bite.
Then hurriedly went to the operating floor, entered the operating room, and saw Wang Haiyang with a livid face.
"The operation is cancelled." Seeing Ling Ran, Wang Haiyang panted heavily, and said, "I was just about to send you a message, go back and rest."
"What's wrong?"
Wang Haiyang hummed twice, but did not speak.
The old nurse next to him was also very angry and said, "The patient's family members thought they were smart, first used shredded tobacco and incense ash to stop the bleeding on the palm of the hand, and then soaked the severed finger in ice cubes. As a result, the ice cubes thawed, which was equivalent to being soaked in water!"
Ling Ran was dumbfounded. It’s nothing more than incense ashes affecting debridement. The nicotine contained in shredded tobacco will constrict blood vessels, which is no problem for small wounds, but it is a big problem for severed finger replantation. As for the severed finger soaked in water, it will cause secondary damage to the tissue.
"Can't meet the stitching standard?" Ling Ran was still a little bit unwilling.
Wang Haiyang gave an "en" and said, "There is no need for sutures, it's rotten."
The domestic index requirements for suturing amputated fingers are very low, so it cannot be achieved, and it can be said that it is indeed impossible to suture.
Ling Ran said helplessly, "Don't the emergency personnel in the ambulance understand?"
When Wang Haiyang wanted to choose the type of disease, he could only pick it from the ambulance in the emergency center to know the condition of the patient.
Wang Haiyang tore off the gloves he had put on, and said, "The fingers were sent by the patient's family. The patient's fingers were simply bandaged. The people in the ambulance recognized the incense ash, but they didn't know there was shredded tobacco."
The equipment nurse also sat down and said: "A thief who is a dead thief is perfect."
"Wait a minute, I'll find another one." Wang Haiyang was a little embarrassed to face Ling Ran, everyone teamed up but disappeared, the captain had to stand up and say something.
Ling Ran could only pat his stomach, he misses Boss Shao a little bit now.
If Boss Shao's finger is broken, he will definitely arrange it properly and come to the hospital.
If you can't get it right, you have to do the disinfection yourself.
Ling Ran sighed, "Then I'll wait in the lounge."
The operating room is very tense, and he has a deep understanding of it himself.
Ling Ran sat in the operating room, turned on Glory of the King, and after three rounds, he waited for another patient.
"The patient is 23 years old. He was chopped up by the adulterer when he caught the adulterer. His index and middle fingers were incompletely severed, and he was contaminated by a large amount of food..." the itinerant nurse introduced while the three doctors were changing their clothes.
Wang Haiyang listened with joy: "This is good, it is not completely broken, and the difficulty is less."
After speaking, he grabbed the patient's finger and looked at it, then frowned slightly, and said, "There are no blood vessels in the connected skin and flesh tissue. After this debridement, the effect will not be great, so it's better than nothing."
Ling Ran watched without saying a word.
He has done hundreds of tang methods, but he has no experience in replanting severed fingers.
Wang Haiyang stood on the operating table and felt better after seeing the patient. He smiled at Ling Ran and said, "I'll do the first operation first, and let's discuss the subsequent operations, okay?"
"Okay." Ling Ran replied very straightforwardly.
"Then let's start. The general sequence of replantation of a severed finger is debridement first, then bone grafting, then tendon stitching, then nerve stitching, blood vessel stitching, and finally skin stitching... Ling Ran, you haven't done bone grafting, have you? ?” Wang Haiyang explained with a smile, like a senior doctor who is good at being a teacher.
"Yes, I didn't take over the severed bones." Ling Ran was doing the job of helping Wang Haiyang, dutifully helping and chatting with Wang Haiyang.
"Then I'll talk more when we get the bone grafted later." Wang Haiyang felt quite comfortable with the operation.
…
At the same time, Lu Wenbin ran wildly in the corridor, muttering while running: It's over, it's over, how could I fall asleep.
… u