"Ling Ran, continue working on the ring finger of your left hand." Wang Haiyang couldn't leave Ling Ran alone and wait for others to finish their work.
Finger replantation is one of the most time-consuming surgeries.
Even more so with surgery today.
If the 5-year-old patient can use all 8 fingers, he must be sutured as quickly as possible.
A good and fast operation is the focus of postoperative recovery of severed finger replantation. Blood supply is very important, and the most important thing is to restore blood supply as soon as possible.
No one knows how long it takes for a severed finger to lose blood and become necrotic, maybe 20 hours, maybe 8 hours, maybe 12 hours The longest ischemic time for a severed finger in a Chinese child is 56 hours, by wu@香验外科The hospital replanted successfully, but presumably no one is willing to take the initiative to challenge the record.
Different people have different situations, one thing is not wrong, you let it restore blood flow as soon as possible, the better it will recover and the more functional it will be.
The replantation of amputated fingers in the first group, the second group and the third group is only about halfway through. No one has completed the most important vascular anastomosis, and the same complicated nerve anastomosis is waiting for everyone...
At their current speed, it won't be over in an hour and a half.
In this case, let alone vacating Ling Ran, it doesn't make sense to let other doctors replace Ling Ran. Ling Ran is the fastest to do it, and he is young and energetic, so it is the most correct choice to let him continue to do it.
The replacement doctors, no matter their speed or quality, could not be compared with the several directors and deputy directors who took part in the battle at this time, so why should they replace Ling Ran
Wang Haiyang didn't have to weigh left and right, and made a decision in the blink of an eye.
He has to be responsible for the entire operation, not for the face of a certain doctor. To put it bluntly, a surgeon who can't perform the operation well has no face.
Especially in a provincial tertiary hospital like Yunhua, most of the surgeons go for the technical route, and they will be looked down upon if they are not good at technology. This is undoubtedly politically correct.
Wang Haiyang is already the chief physician, and he doesn't need to look at other people's faces.
Ling Ran also doesn't consider anyone's face, and refuses the surgery he is good at.
Ling Ran only nodded slightly, said "Okay", and then said: "Ma Yanlin, you continue to sew the skin. Nurse Liu, show me the large MRI scan of the ring finger of your left hand."
Ma Yanlin bit the bullet and continued sewing, which attracted everyone's attention.
Ma Yanlin himself was quite disturbed, and when he picked up the needle holder, his fingers even trembled slightly.
Ma Yanlin couldn't help looking at Ling Ran.
If you change to a warm-hearted senior doctor, there will be about 800 words of consolation at this time, so Ma Yanlin should not be too nervous.
However, Ling Ran didn't even look at Ma Yanlin, as if he was doing normal operations, he just stared at the MRI image in a daze, unlike X-rays and other small methods, the amount of information in the MRI film is extremely high. big. For example, in the films taken by ordinary patients from hospitals, many contents in them are blurred.
Doctors who can read films can get more information from MRI than X-ray eyes.
Ling Ran concentrated on reading the film, but Ma Yanlin calmed down instead.
It doesn't work if you don't stay calm.
As a doctor, you will always encounter all kinds of accidents, and dealing with unexpected situations is the embodiment of a surgeon's ability.
Ma Yanlin still recalled the various operations in the previous operating room. The skin suturing and debridement were the most times he had done, and he had performed surgery several times, which gave him a better understanding of the structure of the human hand.
Although the fingers of a 5-year-old child are small, when doing tang sutures, Ling Ran also performed more than 10 cases of children's tendon sutures. Although the positions were different, the problems encountered were similar. The same goes for the touch of skin, muscle, fat, etc.
Ma Yanlin regained his composure, and gently passed the curved needle through the little patient's skin.
He sewed extremely carefully, and even more so to an incomparable standard.
It's like being in the emergency department.
After a series of operations, if you don't look at Ma Yanlin's face, you can't tell that it was done by Gui Peiyi.
The doctors watching looked at each other and fell silent.
Suturing is a job that practice makes perfect, but ordinary doctors do not have the opportunity to suture for the replantation of severed fingers.
Ma Yanlin, however, has done more than a hundred tang methods, and his proficiency is no less than that of a senior attending doctor. When performing operations on weekdays, skin suturing is just a routine operation.
A person's energy and concentration are limited. The value of a first assistant is to assist the chief surgeon and handle trivial matters. Ma Yanlin had no chance to show his face before, but now he was remembered by several directors and deputy directors of the hand surgery department.
"Doctor Ling, the skin is finished." Ma Yanlin breathed a sigh of relief.
In front of such a group of bigwigs moving the needle, it would be a lie to say it was true.
To put it bluntly, in a tertiary hospital of the size of Yunhua, among a group of resident doctors, if one resident doctor is selected to participate in a major operation, the level of winning is like being selected as a breeding sheep out of a thousand sheep Just as rare.
During Ma Yanlin's regular training, he got such an opportunity, and it was rare to seize it. He was already excited and wanted to do it.
"Next...do the debridement of the ring finger of the left hand." Ling Ran squeezed in as he spoke, taking the position of the chief surgeon.
Ma Yanlin could only squeeze one head sideways, and barely had room to maneuver.
The little patient is currently lying on his back, with his left and right hands open, and there are two groups of doctors on each side, and it is indeed crowded.
Ling Ran and Fei Zhou each occupy the main seats on one side, and the equipment nurse occupies the middle, so the assistants have to do their work.
Ling Ran cleaned up the patient's wounds, then pinched the joints of his fingers, waited for more than ten seconds to observe carefully, sighed secretly, and said: "The finger is broken in the middle of the backbone, and the bone must be shortened. .”
After bone shortening, the fingers will be shorter than normal. However, by this time, there is no need to talk about aesthetics.
As a human being, we have a natural aversion to loss, and few people are willing to admit "sunk costs", and this is when the knowledge and reason of doctors need to come into play.
After the bone shortening is done, the fingers will become ugly after the injury is healed, but if the bone shortening is not done, the only choice is amputation.
The loss occurred not during bone shortening, but at the moment when 8 fingers were pinched off.
The role of a doctor is to reduce the loss as much as possible, but it is seldom that there is no loss at all. In the final analysis, restoring to the original is just a beautiful word.
In terms of probability, the average success rate of severed finger replantation is only about 80%, and the level of "excellent" is even lower.
Even if the hand function is evaluated as excellent, it is still the best among severed fingers, and it will not be exactly the same as normal fingers, let alone compared with more flexible individuals among humans. Long-term medication and rehabilitation are indispensable.
It is pitiful for a 5-year-old child to encounter such a situation, but none of the doctors present would slow down in pursuit of perfection.
Even in order to increase the speed, everyone adopted the strategy of suturing only one artery and part of the nerve, including Ling Ran.
Except for Ling Ran, the surgeons are all doctors who have been operating for 20 or 30 years. No one believes in perfection for a long time.
Any choice comes with a price.
The price of choosing fast may be the incomplete function of one or more fingers, but the price of choosing perfection may be the necrosis of one finger or even three fingers, and in the worst case, other fingers are involved.
Weighing risks is what surgeons do all the time.
This is perhaps the biggest difference between a surgeon and a pilot.
Both surgeons and pilots need strong hands-on ability, abundant knowledge reserves, and timely judgment. The difference is that pilots try to avoid all risks, and surgeons just choose the most controllable risk among various risks. the one.
"Needle holder."
"Steady."
"Give me 12-0."
Ling Ran advanced step by step, which was basically the same as the usual operation method.
And the time he usually takes to replant a severed finger is about an hour and a half.
"The ring finger of the left hand is finished." Ling Ran buried his head in his work and only looked up at his watch after finishing.
In fact, without him having to speak, everyone else noticed Ling Ran's speed.
At this moment, none of the other three groups had completed the replantation of amputated fingers. Seeing Ling Ran making it to the end step by step, the mood of everyone was indescribable.
"Can we continue?" Wang Haiyang asked calmly, even before finishing sewing.
Ling Ran said, "Yes."
"The little finger of my left hand is handed over to you." Wang Haiyang gave Ling Ran the finger that was originally intended for Fei Zhou.
Fei Zhou lowered his head, not knowing what to do, he just comforted himself over and over again in his mind: The quality of my severed finger replantation is higher, and the quality of my severed finger replantation is even higher...