Huo Congjun had been paying attention to Wang Haiyang's expression, and when he saw his expression change, his heart skipped a beat, and he hurriedly asked, "Director Wang, is there a problem?"
Wang Haiyang was silent for a few seconds, and said with some embarrassment: "No."
His embarrassment is that he can't ask a question...
For a chief physician who has been ordered to find fault, this is obviously a bit embarrassing.
However, tendon suturing in hand surgery is originally a simple operation with high technical requirements and low systemic requirements. Ling Ran's operation steps are straightforward, and he really can't find any faults.
As for how the suture was performed, Wang Haiyang could no longer lift the patient's tendon to see.
On the contrary, Huo Congjun was a little unhappy, and said, "Old Wang, you don't need to cover up what you have to say. This is a delicate operation in the rescue. Now I'm looking for a big expert in hand surgery for consultation, isn't it just to see if there is any problem?" Is there anything missing?"
When he said this, the family members of the patient hiding in the corner of the room really showed gratitude.
In the car accident on the highway, the patient was not smashed to pieces, but was in a semi-broken state. If he can save his life, he has reached the minimum expectation of the patient. Director Huo can only care about the function of the patient's hands, and what he will gain will only be gratitude .
Wang Haiyang smiled wryly, and said, "Let's do a hand function assessment. Of course, the patient has just finished the operation, so maybe his condition is not very good. Let's make a reference first."
Hand function assessment is often done in hand surgery, and it is used to evaluate the hand function of patients after surgery.
Wang Haiyang grabbed the patient's hand first, and gently made a few passive movements. After finding that the work was done well, he asked, "Can the patient actively move his hand?"
"On the day Wenhua was sober, Dr. Ling asked to exercise." The family members rushed to answer, and asked with some uncertainty: "Is this good or not?"
Wang Haiyang raised his eyebrows, coughed twice, and said, "It's good if you can move, and it's bad if you can't move."
The family members were greatly encouraged, and hurriedly said: "If you can move, you can move all five fingers, but the movement is not strong, and you can't make a fist."
Another family member of an older patient hurriedly asked: "I can't make a fist yet, is it okay?"
"It doesn't matter." Wang Haiyang was a little dazed when he heard this, and turned to look at Ling Ran, before saying, "The tang method still has some advantages."
Ling Ran smiled and nodded, expressing approval.
A group of residents next to him felt itchy all over their bodies, as if they had gone to the wrong set.
Wang Haiyang stared at the patient and asked him to move each finger to show himself.
The patient who had just had one round of surgery and was waiting for the second round of surgery was a little groggy, but under Wang Haiyang's instructions, he moved his fingers as much as possible.
Slightly mobile, ugly and swollen.
However, it is really active.
"Doctor, how is it?" The family members were still worried.
This time, Wang Haiyang said in a positive tone: "If you can move, it's very powerful. If you can move, it means that there is no tendon rupture... Well, let's make a fist, it must be impossible to hold, it counts as much as you can hold..."
Under his command, Ma Wenhua, who was wrapped into a half mummy, took great trouble to make a big C shape with his left hand.
"Can't do it anymore?" Wang Haiyang asked.
The patient nodded.
"How is it?" Not only the patient's family members but also Huo Congjun were asked this time.
"It's still pretty good." Wang Haiyang coughed twice and said, "Let's do another fingertip pinch."
"Pinch your fingertips together."
"Side pinch."
Wang Haiyang did a round of tests, and the more he did it, the more surprised he became.
The prognosis of hand tendon suture is the most troublesome and important two points, one is tendon adhesion and the other is tendon rupture.
Adhesion of the tendon will limit the function of the hand. It is easier to understand the rupture of the tendon. The stitched tendon is ruptured, and naturally it cannot function at all.
For hand surgeons, the trouble is not either of the two points, the trouble is that the requirements of the two run counter to each other.
It is easy to solve the problem of tendon adhesion alone. The sooner you start moving your hands, the less the problem of adhesion will be, because the adhesion occurs gradually, and the longer the delay, the more serious the adhesion will be.
It is also very easy to solve tendon rupture. The later the hand is moved, the less chance of rupture, because the tendon grows gradually, and the longer it is delayed, the stronger it will grow.
Therefore, tendon adhesion and tendon rupture have become two contradictory sequelae.
Early mobilization can solve the adhesion problem and increase the risk of fracture—if it breaks, you will have to enter the palace again, and it may not be possible to suture it properly again.
Late activities, the chance of breaking is small, the adhesion problem is serious, and many hands cannot be used normally.
To solve this trouble, hand surgery is trying desperately on two routes. At first, many doctors of hand and foot surgery imagined that, like organ transplantation, they could find a drug to prevent adhesion, or obtain a dressing that reduces adhesion, so as to reduce the risk of tendon rupture without tendon adhesion. However, there has never been a decisive drug.
Therefore, early mobilization and increased tendon suture strength became the only route for many years.
The tang method is the one that goes the farthest.
It uses three strands of suture, which greatly increases the strength of the suture, so that it can start the movement earlier.
The Kessler method and double kessler method that Wang Haiyang likes usually start passive activities at 4 o'clock after the operation, the earliest 36 hours, and try active activities after 3 days. Even so, 20% of the tendons will still be broken.
The tang method emphasizes that after 24 hours, active activities begin.
Wang Haiyang has seen surgery before, but he has not observed the prognosis of patients sutured by Tang method.
From the current point of view, the prognosis of patients sutured by the tang method performed by Ling Ran is obviously much better.
"Our hand surgery has always emphasized early mobilization." Facing the patient, Wang Haiyang explained to Huo Congjun, "From our experience, the stronger the early mobilization ability, the better the hand function recovery. However, we cannot say for sure how good it will be.”
In the last sentence, he gave the patient a vaccination, and said: "You must follow the doctor's advice. The final recovery is related to the state of your tendon, the quality of the suture, and your rehabilitation. Rehabilitation is especially important.”
"Then how about our suturers?" The older family members always had some doubts about Ling Ran. After all, in his impression, the older the doctor, the better, just like the expert in front of him.
Wang Haiyang smiled, and asked with experience: "How far do you expect to recover?"
"It must be hope for better." The family member of the patient hesitated for a moment, thinking of the rotten hand that was almost shredded before, and said uncertainly: "At least I should be able to take care of myself."
"That's no problem, your request can be met." When Wang Haiyang said this, the family members were all happy.
Wang Haiyang smiled arrogantly. After suturing the tendons he made by hand, he could reach this level in 3 days. Not to mention taking care of himself, it is possible to cook and even play basketball.
In an instant, Wang Haiyang suddenly felt something was wrong, this stitching was not done by me!
Turning around and seeing the young intern with a serious face who had undergone the operation, Wang Haiyang's thin body suddenly trembled, and suddenly felt that the examination was extremely boring, he was still an intern...