"Ling Ran, continue with the left ring finger." It was impossible for Wang Haiyang to not use Ling Ran and wait for the others to finish their work.
Finger replantation was one of the surgeries that mattered the most.
Today's surgery was even more so.
If they wanted to use all eight fingers of a five-year-old patient, they had to suture him as soon as possible.
A good and fast surgery was the key to postoperative recovery for finger replantation. Blood supply was very important, and it was the most important to restore blood supply as soon as possible.
No one knew how long it would take for a severed finger to die from blood loss. It might take twenty hours, eight hours, or twelve hours. The longest case of a severed finger in China was fifty-six hours, and it was successfully replanted by Wuxi Surgery Hospital. However, no one was willing to challenge the record.
Different people had different situations. One thing was certain. If you restored blood flow as soon as possible, the recovery would be better, and the function would be stronger.
Group One, Group Two, and Group Three were only halfway through the finger replantation. No one had completed the most important blood vessel anastomosis, and there was an equally complicated nerve anastomosis waiting for them …
With their current speed, they would not be able to finish within one and a half hours.
In this situation, forget about making Ling Ran available, it did not make sense for other doctors to replace him. Ling Ran was the fastest, and he was young and energetic. Letting him continue was the best choice.
The doctors who replaced him could not compare to the chief physicians and associate chief physicians in terms of speed and quality. How could they replace Ling Ran?
Wang Haiyang did not need to weigh the pros and cons. He made a decision in the blink of an eye.
He had to be responsible for the entire surgery, and he could not be responsible for a certain doctor's reputation. To put it bluntly, surgeons who could not perform the surgery well did not have any reputation.
This was especially true in a provincial tertiary Grade A hospital like Yun Hua. Most surgeons focused on their skills, and those who were not skilled would be looked down upon. This was undoubtedly politically correct.
Wang Haiyang was already a chief physician, and he did not need to care about other people's reputation.
Ling Ran would also not care about other people's reputation and refuse the surgery he was good at.
Ling Ran only nodded slightly and said, "Okay." Then, he said, "Ma Yanlin, continue suturing the skin. Nurse Liu, show me the MRI scan of the left ring finger. "
Ma Yanlin braced himself and continued suturing the skin, which attracted everyone's attention.
Ma Yanlin also felt uneasy. When he picked up the needle holder, his fingers even trembled slightly.
Ma Yanlin could not help but look at Ling Ran.
If a senior doctor with a warm heart were in Ma Yanlin's shoes, he or she would have used around 800 words of comfort to calm Ma Yanlin down.
However, Ling Ran did not even cast a glance at Ma Yanlin. Just like how he usually did, he stared at the MRI scan in a daze. Unlike X-ray scans, the information contained in the MRI scan was huge. For example, most of the contents of the radiographic films taken by patients in the hospital were blurred.
Doctors who knew how to read scans could get more information from MRI scans than X-ray eyes.
When Ling Ran focused on reading the film, Ma Yanlin calmed down.
He had no choice but to remain calm.
As a doctor, he would always encounter all kinds of accidents. Dealing with unexpected situations was the embodiment of a surgeon's ability.
Ma Yanlin recalled all the things he had done in the operating theater before this. He had sutured the skin and debrided the wounds the most. He had even performed a few surgeries, which gave him a better understanding of the human hand structure.
Although the fingers of a five-year-old child were small, Ling Ran had also sutured more than ten cases of tendons in children using the M-Tang technique. Although the positions were different, the problems he encountered were similar. The skin, muscles, fat, and other sensations were also the same.
Ma Yanlin calmed himself down and gently pierced the young patient's skin with the curved needle.
He sutured very seriously, and his suturing was very standard.
It was just like when he was in the Emergency Department.
After a series of operations, if one did not look at Ma Yanlin's face, they would not be able to tell that it was done by a houseman.
The doctors who were watching by the side looked at each other and did not say anything.
Suturing had always been a skill that came from practice. It was just that normal doctors did not have the chance to suture finger replantation surgeries. If they did not have enough skills, they would not be able to talk about being skillful.
However, Ma Yanlin had performed more than one hundred surgeries using the M-Tang technique. His skill was not inferior to that of a senior attending physician. When he performed surgeries, suturing the skin was just a routine operation.
There was a limit to a person's concentration and concentration. The value of a first assistant's existence was to assist the chief surgeon and deal with trivial matters. Ma Yanlin did not have the chance to show his face before this, but now, he was remembered by a few chief physicians and associate chief physicians of the Hand Surgery Department.
"Doctor Ling, the skin is done." Ma Yanlin breathed a sigh of relief.
It would be a lie to say that he did not feel nervous when he moved the needle in front of such a group of big shots.
To put it bluntly, in a tertiary Grade A hospital like Yun Hua, if a resident doctor was chosen among a group of resident doctors to participate in a major surgery, it would be as rare as being chosen as a breeding sheep among a thousand sheep.
Ma Yanlin got such an opportunity during his houseman training, and it was rare for him to seize it. He was already so excited that he wanted to be the breeding sheep.
"Next … debridement of the left ring finger." As Ling Ran spoke, he squeezed in and occupied the chief surgeon's position.
Ma Yanlin could only squeeze in with his head sideways, and he had to barely have a space to operate.
The young patient was currently lying on his back with both hands open. There were two groups of doctors on both sides, and it was indeed crowded.
Ling Ran and Fei Zhou each occupied the chief surgeon's position on one side. The scrub nurse occupied the middle, and the assistants had to work whenever there was a gap.
Ling Ran cleaned up the patient's wound and pinched the joints of the fingers. He observed the patient for more than ten seconds before he sighed in his heart and said, "The finger is severed at the middle of the shaft. We'll need to perform bone shortening."
After bone shortening, the fingers would be shorter than normal. However, at this point, there was no longer a need to talk about aesthetics.
As humans, they naturally hated losses, and very few people were willing to admit to "sunk costs". This was the time when doctors' knowledge and rationality played a role.
After bone shortening, the fingers would become ugly after the injury was healed, but without bone shortening, they could only choose to amputate the fingers.
The loss was not caused when bone shortening was performed, but when eight fingers were severed.
The role of a doctor was to reduce the loss as much as possible, but it was rare for them to achieve zero loss. At the end of the day, "recovery" was just a beautiful phrase.
In terms of probability, the average success rate of finger replantation was only about 80%, and the chances of it reaching "excellent" were even lower.
Even if the hand function was rated as excellent, it would only be the best among the severed fingers. It would not be exactly the same as a normal finger, let alone be compared to a more flexible human body. Long-term medication and rehabilitation were also indispensable.
It was pitiful for a five-year-old child to encounter such a situation, but none of the doctors present would slow down for the sake of perfection.
In fact, to increase the speed, everyone used the strategy of suturing only one artery and part of the nerves, including Ling Ran.
Aside from Ling Ran, the chief surgeons were all doctors who had been performing surgeries for twenty to thirty years. No one believed in perfection.
There was a price to pay for every choice.
The price of choosing to be fast might be the loss of function in one or more fingers, but the price of choosing to be perfect might be the necrosis of one or even three fingers. In the worst case scenario, the other fingers might be affected.
Weighing the risks was what surgeons did all the time.
This might be the biggest difference between surgeons and pilots.
Both surgeons and pilots needed to have extremely strong hands-on skills and abundant knowledge. They also needed to be able to make timely judgments. The only difference was that pilots tried to avoid all risks, while surgeons only chose the one that they could control the most among all kinds of risks.
"Needle holder."
"Steady."
"Give me 12-0."
Ling Ran pushed forward step by step, and it was basically the same as how he usually operated.
And the time he usually took to perform a finger replantation was about one and a half hours.
"Left ring finger completed." Ling Ran buried his head in his work, and after he was done, he raised his head to look at his watch.
In fact, he did not need to say anything. The others had already noticed Ling Ran's speed.
At that moment, the other three groups had not even completed a single finger replantation. As they watched Ling Ran reach the end step by step, everyone's emotions were indescribable.
"Can I continue?" Wang Haiyang had not finished suturing either, so he still asked calmly.
Ling Ran said, "Yes."
"I'll leave the left pinky to you." Wang Haiyang gave the finger that was originally meant for Fei Zhou to Ling Ran.
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