Chapter 156： Higher quality

"Ling Ran, you then make the third finger of the left hand." Wang Haiyang could not leave Ling Ran unused, waiting for others to finish the work in his hand.

Replantation of broken fingers is one of the most time-consuming operations.

This is even more the case today.

If a 5-year-old patient can use all eight fingers, he must be sutured as quickly as possible.

Good and fast surgery is the focus of postoperative recovery of severed finger replantation. Blood flow is important and restoring blood flow as early as possible is the most important.

No one knows how long the broken finger will be necrotic after blood loss. Maybe 20 hours, maybe 8 hours, maybe 12 hours. The longest case of severe finger ischemia in Chinese children is 56 hours later. The replantation of the hospital was successful, but presumably no one was willing to take the initiative to challenge the record.

Different people have different situations, and one thing is not wrong. You can let it restore blood flow as soon as possible, the better it will recover and the more functional it will be.

The replantation of broken fingers in one group, two groups and three groups was only about half, and everyone did not complete the most important vascular anastomosis. There was also an equally complex neural anastomosis waiting for everyone ...

At their current speed, it won't end in an hour and a half.

In this case, let alone Ling Ran be vacated. It doesn't make sense for other doctors to replace Ling Ran. Ling Ran is the fastest, young and energetic. It is the most correct choice for him to continue.

The replacement doctors, regardless of speed or quality, can't compare with the directors and deputy directors who entered the battle at this time. Why should they replace Ling Ran?

Wang Haiyang didn't have to measure left and right, he made a decision in an instant.

He is responsible for the entire operation, and cannot be responsible for the face of a doctor. He is polite to say that the surgeon who can't perform the operation has no face.

Especially in the provincial top three hospitals like Yunhua, most of the surgeons are on the technical line, and if the technology is not good, they will be looked down on. This is undoubtedly politically correct.

Wang Haiyang is already the chief physician, he doesn't even need to look at other people's faces.

Ling Ran would also not consider anyone's face, and refused the surgery he was good at.

Ling Ran only nodded his head slightly, said "OK", and then said, "Ma Yanlin, you continue to sew the skin. Nurse Liu, show me the big MRI of the left ring finger."

Ma Yanlin stiffened her head and continued to sew, attracting everyone's eyes.

Ma Yinglin himself was also very disturbed. When he picked up the needle holder, his fingers even shook slightly.

Ma Yanlin could not help looking at Ling Ran.

If you change to a warmer senior doctor, there will be a word of consolation at this time, so Ma Yanlin should not be too nervous.

However, Ling Ran didn't even look at Ma Yilin. It was just like the operation on weekdays. He looked at himself with a magnetic resonance image in a daze, unlike a small handle like X-rays. Big. For example, many videos taken by patients from hospitals are blurred.

Doctors who can read the film can see more information from MRI than through fluoroscopy.

Ling Ran focused on reading the film, but Ma Yanlin calmed down.

Not calm down.

As a doctor, you will always encounter all kinds of accidents. It is the surgeon's ability to deal with accidents and situations.

Ma Yilin more often recalls the previous operating room. He sutured the skin and debrided the most times. He had done several times in the operation, which gave him a better understanding of the human hand structure.

Although the fingers of 5-year-old children are small, when performing tang suture, Ling Ran also performed sutures of more than 10 children. Although the positions were different, the problems encountered were similar. Skin, muscle, fat, and so on are also the same.

Ma Yanlin was so calm that the curved needle passed gently through the skin of the young patient.

He sewed extremely carefully, and it was an incomparable standard.

It's like in the emergency department.

After a series of operations, if you don't look at Ma Yanlin's face, you can't see that it was done by Ji Peiyi.

The onlookers looked at each other and did not say a word.

Suturing is a skill that can be used in practice, but ordinary doctors do not have the opportunity to do sutures for replantation of broken fingers. The number of operations is not available, and it is impossible to talk about Qiaojin.

Ma Yanlin did more than a hundred sets of tang method. She is no less skilled than a senior attendant. When performing surgery on weekdays, suture the skin is only a routine operation.

A person's spirit and concentration are limited. The existence value of the first aid is to assist the main knife and handle trivial matters. Ma Yilin had only had no opportunity to show his face before, but was remembered by several directors and deputy directors of hand surgery.

"Doctor Ling, the skin has been sewn." Ma Yilin breathed a sigh of relief.

It is false to move the needle in front of such a group of big men.

You're welcome. In the top three hospitals of Yunhua's size, a group of residents can be seen and participated in a major operation. The winning level is like a sheep selected from a thousand sheep. Just as rare.

During the training period, Ma Yilin was given such an opportunity, and he rarely caught it. He was already excited to plant seeds.

"Then ... do the debridement of the left ring finger." Ling Ran squeezed in and occupied the position of the main knife.

Ma Yilin could only squeeze into a head sideways, and then barely had room for operation.

The small patient is currently in the supine position, with both left and right hands open, and there are two groups of doctors on each side, which are indeed crowded.

Ling Ran and Fei Zhou each occupy the main position on one side, the equipment nurse occupies the middle, and the assistants can see the stitches working.

Ling Ran brushed to clean the patient's wound, then pinched the joints of his fingers, and carefully observed for more than ten seconds, sighing secretly, saying, "Fingers are broken in the middle of the backbone, and the bone must be shortened. . "

When the bone is shortened, the fingers will be shorter than normal. However, at this time, it is not necessary to talk about the problem of aesthetics.

As human beings, natural aversion to loss, and few people are willing to admit "sinking costs", and this is when the knowledge and rationality of doctors are needed to play a role.

After shortening the bone, after the injury, the fingers will become ugly, but without bone shortening, you can only choose amputation.

The loss did not occur when the bone was shortened, but at the moment when eight fingers were pinched.

The doctor's role is to reduce the loss as much as possible, but rarely can not achieve the slightest loss. In the final analysis, recovery is just a beautiful word.

In terms of probability, the average success rate of replantation of broken fingers is only about 80%, which can reach the "excellent" level.

Even if the hand function is evaluated as excellent, it is also excellent in broken fingers, not the same as normal fingers, let alone compared with the more flexible individuals in 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 will slow down in pursuit of perfection.

Even to increase speed, everyone has adopted a strategy of only one artery and part of the nerves ~ www.novelhall.com ~ including Ling Ran.

Except for Ling Ran, who are the main surgeons, they are all doctors who have performed surgery for 20 or 30 years. No one has long believed that it is perfect.

Any choice comes at a price.

The price of choosing fast may be the function of one finger or multiple fingers, but the price of choosing the perfect one may be necrosis of one finger or even three fingers. In the worst case, other fingers are involved.

Weighing risk is something that surgeons do every moment.

This is perhaps the biggest difference between a surgeon and a pilot.

Both surgeons and pilots need strong hands-on ability and abundant knowledge, and they also need timely judgment. The difference is that pilots try to avoid all risks. The surgeon only chooses the most control among all risks The one.

"Needle holder."

"Stabilize."

"Give me 12-0."

Ling Ran's step-by-step advancement is basically consistent with the usual operation method.

The time it takes for him to replant a broken finger is about an hour and a half.

"The ring finger of the left hand is completed." Ling Ran drew his head to work and looked up at his watch after finishing.

In fact, without him speaking, everyone else noticed Ling Ran's speed.

At this moment, the replantation of the broken fingers of the other three groups was not completed, and Ling Ran stepped to the end step by step. The mood of everyone was also inexplicable.

"Can you continue?" Wang Haiyang himself did not finish sewing, and asked calmly.

Ling Ran said: "Yes."

"The left thumb is in your hand." Wang Haiyang gave Ling Ran the finger originally intended for Fei Zhou.

Fei Zhou lowered his head and didn't know how to do it. He only comforted himself over and over in his mind: The quality of the replantation of broken fingers was higher.