In the afternoon.
Ling Ran, who had his fill, sat on the chair in the office. He opened his laptop and looked out the window. He looked at the corner of a building in front of him and fell into deep thought.
The sunlight shone on the ground, and it was warm.
On his left was a cup of lemon kumquat and passion fruit tea sent by the nurses' station. There were ice cubes in the cup, and the tea was foggy and cool. On his right were three sets of snacks sent by the patient's family members.
Although they were not allowed to receive red packets, they were still allowed to give food to the patients and their family members. However, most of the fruits and snacks sent by the patients and their family members were given to all the people in the department. Only after Ling Ran came to the department did they say that they were given to a certain doctor.
"Are you full?" Huo Congjun returned to the office and saw Ling Ran's well-rested appearance. He nodded in satisfaction.
Ling Ran hummed in acknowledgment and asked, "Is the patient here?"
"Wang Haiyang is looking at the information. He hasn't decided yet," Huo Congjun said and asked, "Did you buy chocolate or something?"
"I bought one." Ling Ran showed a large piece of Dove chocolate. He bought it from the vending machine.
"Not enough." Huo Congjun looked at it and shook his head. "Finger replantation surgery might take a long time. What if you get hungry?"
"I've never heard of any other doctors eating in the operating theater …"
Huo Congjun pursed his lips and said, "That's who they are. The Emergency Department's secret is to drink and eat well before the war, to find time to eat and drink well during the war, and to eat and drink well after the war to replenish your energy … Hey, give Ling Ran two Snickers bars."
A young resident doctor came over with a Snickers bar.
Ling Ran had no choice but to put it away and give a set of snacks.
Huo Congjun nodded. "When you go in, listen to Wang Haiyang first. Chief Wang asks you to take over before you take over. Although they are all microsurgeries, finger replantations are different. "
"Hahahaha, hahahaha."
Ling Ran did not say anything, but the chair next to him shook and let out a strange sound.
Huo Congjun and Ling Ran naturally looked over and saw Lu Wenbin shaking on the chair. He could not stop even if he wanted to.
Lu Wenbin was embarrassed by the stares. He stood up abruptly and smiled sheepishly. "I'm just a little excited."
He was the chosen second assistant, and it was also his first time participating in a finger replantation.
Huo Congjun said unhappily, "Why weren't you excited when I asked you to save patients in the past?"
Was he jealous? Lu Wenbin said happily and nervously, "I was excited too, even more excited. It's just that I didn't have time to shake at that time, so I didn't realize …"
Huo Congjun hummed in acknowledgment and said to Ling Ran, "Don't go too far. Enter the operating theater at any time."
After he said that, Huo Congjun left the office.
Lu Wenbin was so nervous that his legs were trembling. "Did I say something wrong? What does Department Director Huo mean? "
He subconsciously looked at Ling Ran, only to see that Ling Ran was bathed in sunlight, and his face was almost shining with holy light.
Instead, the fingers on both of his hands were moving quickly and rhythmically.
Ling Ran was obviously simulating the process of suturing a severed finger. Compared to the M-Tang technique, the focus of a severed finger was shifted from the tendon to the blood vessels. The flexor tendons of the fingers were as thick as two or three rubber bands, and the blood vessels were usually within 0.5 millimeters, which was the thickness of the tip of a pen. The difficulty of suturing them was self-evident.
Small blood vessels would also bring about the problem of thrombosis.
Thrombosis was an extremely dangerous existence. It could be said to be a major cause of death and disability in hospitals. To prevent thrombosis, during the nursing process after a severed finger was sutured, the nurses would continuously cut the wound to inject heparin.
The prerequisite for the use of heparin was that the surgeon needed to stabilize the needle insertion.
Blood vessels that could not be sutured stably were not so obvious in other parts of the body, but they were definitely not allowed in the Hand Surgery Department's finger replantation.
It could be said that stable sutures under a microscope were the biggest difficulty in finger replantation. The Hand Surgery Department of Yun Hua Hospital spent millions of RMB to set up a training room, and the annual expenditure was more than a million RMB just to train the young doctors in suturing skills.
If it were in other departments, everyone would directly operate on the patient. No one would be willing to play with the tail of a lab rat after work.
However, the Hand Surgery Department did not do this, and the accident rate was too high. So in recent years, hospitals had built their own training rooms.
Lu Wenbin knew that when Ling Ran first started his internship, he completed the graduation level of the Hand Surgery Department's training room. So, he stared at Ling Ran's fingers, trying to see the main points of his operation.
Retraction could be done without thinking, but Lu Wenbin wanted to learn it with his brain.
As he watched …
As he watched …
Lu Wenbin fell asleep quietly. The sun shone on his cheeks, and it was refreshing and ticklish.
"The patient is coming." Ling Ran's phone rang. It was a WeChat message from Chief Physician Wang Haiyang.
Ling Ran opened his eyes abruptly, tore open the packaging of the chocolate, and finished it in one bite.
He then rushed to the surgical floor. When he entered the operating theater, Ling Ran saw Wang Haiyang with a pale face.
"The surgery is canceled." When Wang Haiyang saw Ling Ran, he panted and said, "I was just about to send you a message. Go back and rest."
"What's wrong?"
Wang Haiyang snorted and did not say anything.
The old nurse beside him was also furious. She said, "The patient's family thought they were smart. They first used tobacco and incense ash to stop the bleeding on the palm, then soaked the severed finger in ice. In the end, the ice melted, and it was equivalent to soaking in water!"
Ling Ran was dumbfounded when he heard that. It was fine if the incense ash affected the debridement, but the nicotine contained in the tobacco would constrict blood vessels. It was naturally not a problem for small wounds, but it was a big problem for finger replantation. As for the severed finger being soaked in water, it would cause secondary damage to the tissue.
"It can't meet the standard for suturing?" Ling Ran was still a little unwilling to admit defeat.
Wang Haiyang hummed and said, "There's no need to suture it anymore. It's rotting."
The standard for finger replantation in China was very low. If they still could not meet the standard, it could be said that they really could not suture it.
Ling Ran said in resignation, "Don't the paramedics in the ambulance understand it too?"
If Wang Haiyang wanted to choose the type of disease, he could only choose from the ambulance in the Emergency Medical Center to know the patient's condition.
Wang Haiyang pulled off the gloves he wore and said, "The finger was sent by the patient's family. The patient's finger was simply bandaged. The people in the ambulance recognized the incense ash, but they didn't know that there was tobacco. "
The scrub nurse also sat down and said, "Well done."
"Wait, I'll go find another one." Wang Haiyang was a little embarrassed to face Ling Ran. Everyone had formed a team, but the boss was nowhere to be seen. The team leader had to stand up and say something.
Ling Ran could only pat his stomach. He kind of missed Boss Shao now.
If Boss Shao's finger was severed, he would definitely arrange for him to come to the hospital.
He might even disinfect it himself.
Ling Ran sighed and said, "Then I'll wait in the waiting room."
The operating theater was very tense, and he knew it very well.
Ling Ran sat in the operating theater and opened Kings of Glory. After three rounds, another patient came in.
"The patient is twenty-three years old. He was slashed by his adulterer when he caught him in the act of adultery. His index and middle fingers are not completely severed, and they are contaminated by a lot of food …" The circulating nurse introduced the patient while the three doctors were changing clothes.
Wang Haiyang was amused when he heard that. "This is good. It's not completely severed, so it's less difficult."
As he spoke, he grabbed the patient's finger and looked at it. He then frowned slightly and said, "There are no blood vessels in the connected skin and flesh tissue. After this debridement, it won't be very useful, but it's better than nothing."
Ling Ran looked at him without saying a word.
He had performed hundreds of surgeries using the M-Tang technique, but he did not have much experience when it came to finger replantation.
Wang Haiyang stood at the operating table. He was in a good mood when he saw the patient. He smiled at Ling Ran and said, "I'll do the first surgery first. We'll discuss the other surgeries later, okay?"
"Okay," Ling Ran answered straightforwardly.
"Then, let's start. The normal sequence of finger replantation is debridement of the cross-section first, then the bone is reconnected, then the tendon is sutured, the nerves are anastomosed, the blood vessels are anastomosed, and finally the skin is sutured … Ling Ran, you've never reconnected a bone before, right?" Wang Haiyang explained with a smile, just like a senior doctor who was good at teaching others.
"Yes, I've never reconnected a severed bone before." Ling Ran played the role of the first assistant. He dutifully helped Wang Haiyang and chatted with him.
"Then, when we reconnect the bone later, I'll talk more." Wang Haiyang's surgery was quite enjoyable.
…..
At the same time, Lu Wenbin ran madly in the corridor. As he ran, he mumbled, 'Oh no, oh no, how could I fall asleep?'
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