Finger replantation debridement and suturing were much more advanced than finger replantation debridement and suturing.
Lu Wenbin dealt with the severed finger on one side, while Ling Ran dealt with the other side with Ma Yanlin's help.
The three of them lowered their heads, wore surgical magnifying glasses, and dealt with the wound bit by bit.
Compared to normal debridement and suturing, finger replantation debridement and suturing had to be done cleanly without losing too much tissue, and the latter was the most troublesome. If too much skin was cut off, skin flap grafts would be needed. If too much tendon was cut off, blood vessels would be shaved off.
Lu Wenbin was only qualified to perform finger debridement alone after he followed Ling Ran for more than a hundred cases using the M-Tang technique. This was also the simplest step in suturing a severed finger.
After debridement was completed, Ling Ran performed bone and joint fixation. Then, he used the internal fixation nails provided by Changxi Medical Company to lock the anastomosed joints. After a series of operations, forty minutes had passed.
Ling Ran raised his head and rested for a few seconds before he asked someone to bring over a high-precision microscope.
The high-precision microscope of Yun Hua Hospital was like a huge table lamp. It had four wheels, and the lamp head was the main part of the microscope. The body was very heavy, and the magnification was enough to see the small blood vessels and nerve fibers in the skull.
Finger replantation surgeries could be performed with ordinary surgical magnifying glasses, but it was a little more difficult. In fact, finger replantation surgeries in the early days often did not use microscopes. Even in the twenty-first century, some small hospitals in some places would still perform finger replantation surgeries with the naked eye. If it succeeded, then it succeeded. If it failed, then it failed.
Ling Ran could not stand the roughness of doing blood vessel anastomosis with the naked eye.
If he did not have the conditions, he could still bear with it. But when he had the conditions, Ling Ran would not feel good when he saw the twenty-four stitches were not aligned.
If he had Master Level Suturing Skills and the stitches were uneven under a microscope, it would be even worse.
Therefore, even though Ling Ran had just started performing finger replantation surgeries, he first asked for a high-precision microscope. One was worth around a million RMB, and it was considered a treasure in a private hospital. In Yun Hua Hospital, it was just an ordinary one. Huo Congjun gave a call, and one was brought over.
Of course, this was only because Ling Ran wanted to use it, and he could indeed use it. If it were any other attending physician who requested it, it would not be so easy to negotiate.
Ling Ran kicked a stool over and sat on it. Then, he started operating on the patient's severed finger with a microscope that looked like a table lamp.
He first sutured the most familiar tendon. Compared to the M-Tang technique, the suturing of tendons in finger replantation surgery was much simpler. After all, there was no problem with the flexor tendon sheath, and postoperative adhesion was also easier to deal with.
In less than twenty minutes, Ling Ran finished suturing the tendon at an incredibly slow pace.
During this process, he used most of the time to familiarize himself with the equipment. Even though he had practiced many times before, he still needed to be more cautious when he was actually using it.
"Judging by the length of the blood vessels, I should be able to anastomose them directly." Ling Ran made a decision after making some judgments.
If the length of the blood vessel was long enough, it could be anastomosed. If the length was not enough, they would need to do vascular reconstruction, which was a vascular transplant. They would cut off a section of the patient's blood vessel and suture it. Naturally, it was much more difficult.
This was also one of the reasons why debridement and suturing had to be done very meticulously.
Ling Ran leisurely took half an hour to complete the blood vessel anastomosis.
On one hand, he did not deliberately pursue speed. He even deliberately slowed down to ensure that the stitches were fine. On the other hand, the blood vessels in the severed finger were indeed very small. Every stitch had to be fully prepared. If he succeeded in one go, the pressure brought about by it was not small.
After he finished suturing a blood vessel, Ling Ran's forehead was already covered in fine beads of sweat.
"Are you okay?" Huo Congjun's voice came from behind, and it shocked Ling Ran.
When he turned around, he saw Huo Congjun wearing a large white coat with his hands behind his back. He was smiling like an old man who was taking a walk with his bird.
"There's no problem with the surgery." Ling Ran glanced at Huo Congjun strangely and asked, "Did something happen?"
"How can there be so many accidents?" Huo Congjun shook his head and said, "What's wrong? You're allowed to perform surgery at three in the morning, but I'm not allowed to come to the operating theater at five?"
"The surgery is still under your name," Ling Ran said indifferently.
"It's good that you still remember. So, how was the surgery today?" As Huo Congjun spoke, he picked up a round stool from behind him and placed it under his butt.
Su Jiafu clenched his fists tightly. He was filled with indignation. 'How dare you snatch an anesthetist's stool? Where's your humanity?'
"One more nerve anastomosis, and it's almost done." Ling Ran gave a simple introduction and continued with the surgery.
Huo Congjun said again, "I heard from the nurse that the patient has been smoking for fifteen years?"
"Yes."
"Do you think the patient will quit smoking?"
"I don't know."
"So, you don't care whether the patient quits smoking or not?"
"Basically." Ling Ran's eyes fell on the eyepiece and he said, "I can't make a decision for the patient just because I sutured one of his fingers, right?"
Huo Congjun was stunned for a few seconds before he chuckled.
Ling Ran looked back and continued with the surgery.
Huo Congjun did not leave either. He stared at Ling Ran's operation from behind. No one knew what he was thinking.
Ling Ran only announced the completion of the surgery at seven in the morning.
Huo Congjun stood up and said thoughtfully, "There's a child's finger replantation surgery now. Are you willing to participate?"
Ling Ran looked at Huo Congjun, puzzled. "What do you mean?"
"A five-year-old child had eight fingers severed by the hotel's automatic door. He has been sent to our hospital's Hand Surgery Department." Huo Congjun paused for a moment and said, "The Hand Surgery Department plans to set up four groups at the same time to cooperate in finger replantation surgery. If you're willing to participate, you can start preparing now."
There was too much information in Huo Congjun's words. Ling Ran only reacted after a while. He asked again, "Is it a crush injury of eight fingers? Is it a complete or incomplete amputation? If there are four groups, does each group perform two fingers? "
"Yes, incomplete amputation, yes," Huo Congjun answered briefly.
"Is the Hand Surgery Department willing to let me join?" Ling Ran asked another key question.
Huo Congjun said calmly, "They don't have enough people."
"The doctors in the Hand Surgery Department are not fewer than the Emergency Department, right?"
"There are only a few who can perform finger replantations for children." When Huo Congjun said this, he could not help but smile. "If you go, they have no reason to refuse."
A five-year-old child performing finger replantation surgery with eight fingers, and it was a collaboration between four groups. Such a major surgery was also an atypical surgery in Yun Hua Hospital.
And in an atypical surgery, the department they belonged to was not that important.
If Ling Ran's skills were good enough, he was qualified to participate.
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