Ling Ran rushed to the operating theater.
Lu Wenbin, who had been pretending to be strong, immediately breathed a sigh of relief and quickly reported, "The patient's skin temperature has dropped by 2.5 degrees Celsius. His skin is pale, and the degree of swelling has increased. I've given him …"
"He smoked?" Ling Ran was not surprised.
Nicotine dependence was extremely strong, and the difficulty of quitting was not any easier than smoking.
Ordinary people might fail to quit smoking even if they had a strong subjective will. Smokers who received finger replantations did not expect their fingers to be amputated, and they were not prepared to quit smoking. There would always be people who did not follow the doctor's order to quit smoking. It was also because of this that a large number of orthopedists in Europe and the United States refused to perform finger replantations for smokers.
Lu Wenbin did not expect Ling Ran's reaction to be so slight. He nodded and said, "I heard that he inhaled twice. This time, he only inhaled once."
"It doesn't matter how much." Ling Ran went to check on the patient and asked, "Did the patient's family sign the surgery consent form?"
"Yes. I told them that I suspected that there was an embolism at the anastomosis, so I need to remove the anastomosis and reconnect the artery. I also told them that the risk of the second surgery is very high, and the patient's family insisted on keeping the finger. "Lu Wenbin was a little depressed. Even if the second surgery was successful, blood circulation might not be established, and the finger's functionality in the future could not be compared to before.
For a resident doctor who had just started performing finger replantations and felt a sense of achievement, this was worse than twenty hours of continuous work.
Ling Ran never showed his emotions, so he did not say much. He only said, "Then do it."
Reconnecting the artery was much simpler than finger replantations. He only needed to make a few more cuts. For him, from confirming the location of the embolism to reconstructing the blood vessel, it was just a workload of half an hour, and he had even deliberately slowed down.
When he performed the finger replantation last time, Ling Ran had already considered the possibility of nicotine ingestion. Hence, when he sutured the finger, he sutured an extra blood vessel to increase the rate of blood circulation.
This time, Ling Ran also tried his best to protect Mao Haipeng's blood vessel to leave enough space for blood circulation.
After the surgery, the medical staff in the operating theater were not in the mood to chat.
The blood circulation crisis did not happen in an instant. When such a serious vascular embolism appeared, the condition of the blood vessels in the severed finger was not optimistic. It was just like a highway that was blocked by traffic. There might be many roads that were blocked by cars …
Due to the stimulation of nicotine, the body that had been injured many times was likely to supply more platelets. Based on the literature, if the rats with tail replantation smoked, the absorption rate of platelets would increase by 10%. Correspondingly, the growth rate of endothelial cells would also decrease. The growth rate of endothelial cells was only one-fifth of that of normal rats.
Ling Ran could use surgery to remove the embolism at the anastomosis, but he could only use use of medicine. of it. of medicine. of medicine of medicine.
The biggest difference between medication and surgery was that surgery was dominated by the doctor, while the effects of medication were often related to the adaptability of the person.
For example, the anticoagulant heparin was generally very effective, but there were always people who were extremely effective or extremely poor.
At this moment, if he wanted to save Mao Haipeng's finger, the medicine given to him would only have a general effect. It might not be good enough.
Lu Wenbin also saw this. After the surgery, he deliberately said, "Why don't I stay in the hospital and look after Mao Haipeng?"
Ling Ran took off his gloves and surgical gown. He thought about it for a few seconds and said, "Okay."
"I will try to save the finger." Lu Wenbin was familiar with Ling Ran's personality. He took the initiative to say, "Then I won't participate in the surgery tomorrow."
"Okay. Take a day off tomorrow. Stop the surgery. "Ling Ran no longer requested to perform a lot of surgeries every day. Compared to the M-Tang technique, finger replantation was more exhausting. It was the same for spirit, energy, and time.
Even if Ling Ran's body was good, Lu Wenbin and Ma Yanlin would not be able to handle it sooner or later.
After all, when it came to the stage of finger replantation, the responsibility of an assistant had also increased. He was no longer just a person who operated the retractor. In addition, the two of them still had to do ward rounds, write medical records, give medical advice, and other trivial matters. Even if they took turns, they still could not relax.
After the interlude of the smoke man today, Ling Ran also wanted to rest.
Lu Wenbin, on the other hand, completely gave up on resting.
Finger replantation was similar to other surgeries. There were a lot of problems in the early stages. If they could get through it, the replanted finger would have a high chance of survival.
Lu Wenbin stayed up all night and gave medical advice to match the medicine at any time, hoping to increase the success rate.
The next day, Lu Wenbin still did not leave Mao Haipeng's side.
Then, he stayed up all night.
During this period, Lu Wenbin only slept intermittently. He would wake up at the slightest sign of movement or the vibration of his phone.
Lu Wenbin was actually not unfamiliar with this kind of life. He did this when he cooked pork trotters. He calculated the time, put in the raw ingredients, and seized the free time to rest and sleep …
However, compared to pork trotters, waiting for the color of the finger to change was a little more difficult.
On the third day.
Ling Ran did his ward rounds as usual.
Lu Wenbin stood up with messy hair and stood on the other side of the hospital bed with the family members.
Mao Haipeng looked ahead expressionlessly. His finger was still grayish-white, and there was even a hint of blackish-gray.
"Let me take a look at the medication record." Ling Ran asked for the medical record and read it from top to bottom.
Unlike internists, surgeons' medication was usually simple and crude. Their aim was to solve the symptoms, and they did not pursue a deeper level of causality. Even so, Ling Ran could still see Lu Wenbin's attempts and hard work from the medical advice.
Lu Wenbin tried his best to expand blood vessels, reduce blood viscosity, increase recovery ability, strengthen cardiopulmonary function … Lu Wenbin did everything he could.
Ling Ran put down the medical record and looked at Lu Wenbin.
Lu Wenbin's gaze was unfocused. He did not want to meet Ling Ran's eyes.
Ling Ran waited quietly.
After a long time, Lu Wenbin finally said in a hoarse voice, "We can't save it … Let's amputate it."
When Mao Haipeng's wife heard him speak, she was already mentally prepared, but when she heard the end, she still could not help but cry. "Why … why do we still have to amputate it? We used so much medicine, and we suffered twice …"
The woman continued to cry, and Ling Ran could only watch her quietly. If he could predict the future, he might have made a different decision, such as amputating it straight away, or using stricter methods to quit smoking. At the very least, he could have given up on reattaching it a second time, or even refused Lu Wenbin's request to take care of the patient. It would have saved him a lot of resources, and he could have saved the patient and his family's efforts, be it money, energy, time, mental trauma, or physical torture.
But what if he could not predict the future?
Ling Ran thought that he would most likely still perform finger replantation for Mao Haipeng.
Nicotine did not necessarily lead to amputation, and Mao Haipeng did not necessarily smoke …
"Amputation is the only choice for now." Ling Ran could finally give an answer that was certain for once.
The woman cried and said, "Can't we just amputate it? How can we do it without fingers … "
"A necrotic severed finger is a huge risk to the other fingers. It's best to send it to the operating theater now. "Ling Ran looked at his watch and said," Let's finish it as soon as possible. "
The patient's family hesitated, but in the end, they all looked at Lu Wenbin.
"We can only amputate it." Lu Wenbin was also helpless.
After a few more words of persuasion, the family finally signed a new informed consent form. Mao Haipeng was also immediately pushed into the operating theater.
Six hours later.
Ling Ran stood in front of Mao Haipeng again.
Mao Haipeng's entire hand was wrapped up, and one of his fingers was missing. But he seemed to be a little more energetic.
When he saw Ling Ran, Mao Haipeng was a little excited. He mumbled, "Thank you." Then, he coughed violently and spoke a little more clearly, "Doctor Ling, sorry to trouble you."
"How do you feel?" Ling Ran asked.
"It's alright. I don't want to recover anymore, and the pressure is a little less." Mao Haipeng showed an ugly smile. He could be said to have somewhat accepted it.
"I still have to do rehabilitation … Hmm …" Ling Ran paused for a moment, because a new Basic Treasure Chest had just appeared in front of him.
[Achievement: Patient's Sincere Gratitude]
[Achievement Description: A patient's sincere gratitude is the greatest reward for a doctor.]
[Reward: Basic Treasure Chest]
Ling Ran looked at Mao Haipeng in shock. It was the first time he saw a patient who could give him Sincere Gratitude twice.
He waved his hand and opened the Treasure Chest.
Amidst the flowing lights and vibrant colors, another silver-gray book appeared, and on the title page was written impressively:
[Interrupted Horizontal Mattress Inverted Suture Technique (Specialist Level), also known as Hermes' Suture Technique. It is mostly used for the suture of the seromuscular layer of the gastrointestinal tract.]
Ling Ran was shocked again. It was also the first time he saw someone opening two chests in a row.
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