Chapter 124: Haven’t Even Named It Yet!
September 19th, cloudy.
On September 19th, at 7:30 AM, Lu Cheng received a call from Professor Zhong Junyun: “Xiao Lu, prepare yourself. We have an emergency limb replantation case. Come to the operating room and get on the table with me.”
Lu Cheng hadn’t expected Zhong Junyun to get his contact information, but he was surprised that Professor Zhong Junyun would contact him proactively.
Lu Cheng stopped his car at the entrance to the ground parking lot of the Experimental Building: “Teacher, what about my class then?”
“You won’t be attending the teaching surgery later. There are only two surgeries, one operating table, how many people can fit?”
“Lan Hualuo can teach you during the teaching surgery, and I can teach you too. Come over here, I’ll send you the emergency operating room number later.” Zhong Junyun hung up the phone.
He didn’t ask for Lu Cheng’s opinion, but instead domineeringly and proactively rearranged Lu Cheng’s ‘study’ plans on the spot.
Mu Nanshu quickly said: “You should go quickly. Professor Zhong’s specialization and achievements in hand surgery should be even better than Professor Lan’s.”
“He’ll give you one-on-one teaching. This is the kind of treatment an associate professor in hand surgery gets…”
“Although it might be compensation, take it if you can. Professor Zhong doesn’t owe you anything.”
Lu Cheng nodded: “Okay.”
Lu Cheng slowly started the car. Since it was Saturday, there were people going to the Experimental Building, but not too many!
“It’s not that I’m hesitating whether to go, I’m just doubting if I’m qualified enough to be valued so highly by Teacher Zhong.”
Lu Cheng kept his speed steady around forty yards, speaking cautiously: “After all, my opportunities haven’t been very good over the years.”
Mu Nanshu said: “Is there anything about you that Professor Zhong would covet? Don’t overthink it…”
“Mhm, okay.”
“Then, about dinner this afternoon, it will depend on the situation.” As the second toll gate of the ground parking lot opened, Lu Cheng slowed down and said.
“I can handle it myself.” Mu Nanshu knew that Lu Cheng might invite Professor Zhong Junyun to dinner.
…
Lu Cheng followed Professor Zhong Junyun’s instructions and found Emergency Operating Room Room 9.
Lu Cheng, fully scrubbed in surgical gown and pants, pushed open the airtight door of the operating room. The sound of rolling wheels tickled his ears, and his vision opened up.
Lu Cheng realized he didn’t recognize anyone in the operating room, not even Professor Zhong Junyun. He started looking around.
After Lu Cheng looked around for a moment, Zhong Junyun’s voice came: “Lu Cheng, wash your hands… and come directly to the table.”
Lu Cheng then realized that Professor Zhong Junyun was already at the operating table, his back to him. Those standing around could be operating room staff or others from the hand surgery department.
Lu Cheng immediately withdrew and began to wash his hands according to the standard procedure.
After putting on a sterile surgical gown and sterile gloves, Lu Cheng, with his hands crossed over his chest, slowly moved to the patient’s leg area next to the operating table, found a spot, and sat down, his gaze serene.
“Xiao Pan, make some room. I’m going to have Xiao Lu assist me with this surgery,” Zhong Junyun instructed directly upon seeing Lu Cheng approach.
“Got it, Master.” The person called Xiao Pan glanced at Lu Cheng, then got up and moved aside.
“Thank you, Teacher Pan,” Lu Cheng said politely.
“Call me Brother Pan…” Pan Leiming replied instinctively, then corrected himself: “No, Brother Lu, you can just call me Xiao Pan.”
Pan Leiming was only twenty-eight years old, younger than Lu Cheng, but he had already graduated and become a chief resident due to his qualifications.
“Hello, Brother Pan,” Lu Cheng said, not daring to call him that.
“Let’s drop the ‘brother’ thing and get to work. This is an upper arm amputation, no fracture, a standard limb replantation case…” Zhong Junyun briefly introduced the situation and then added:
“Xiao Lu, there’s no nerve injury, only severed blood vessels and muscles. It’s a good chance to check your basic skills.”
“Suturing material for blood vessels,” Zhong Junyun commanded the circulating nurse without specifying the size.
“One 7-0 Ethicon vascular suture, please,” the circulating nurse reported in detail as she opened the suture package.
Lu Cheng smoothly used the needle holder to grasp the suture, slightly adjusted the angle of the needle holder, and placed it in the basin. Then, he carefully began to search and examine the surgical field with micro-tweezers.
This was not taught by Zhong Junyun, but a habit of Professor Deng Yong from Zhongnan Hospital’s Trauma Surgery department, who often lectured when Lu Cheng was there.
He also advised that no matter who asked you to come to the operating table or instructed you to perform any procedure, do not act rashly before carefully reading the surgical field.
Acting without understanding is a major surgical taboo.
Since Lu Cheng had just arrived and hadn’t participated in the hemostasis with Professor Zhong Junyun and the others, he was naturally confused.
As Lu Cheng carefully searched, he indeed found something unusual.
This surgery had not yet been thoroughly debrided, as Lu Cheng discovered foreign matter of unknown origin.
Seeing this, Lu Cheng quickly used tweezers to grasp it and placed it in another basin, alongside the debris removed during debridement.
Lu Cheng looked up and glanced at Zhong Junyun: “Teacher Zhong, what was the mechanism of injury for this patient?”
Different injury mechanisms require different levels of debridement. It certainly wasn’t a simple sharp instrument or saw injury.
Although he didn’t know the ultimate purpose of Professor Zhong Junyun asking him to suture the blood vessels directly, Lu Cheng trusted his basic surgical knowledge more.
“Sharp object abrasion!” Zhong Junyun stated.
Lu Cheng’s eyes darted around, and then he buried his head again to search for foreign objects, and also meticulously checked all bleeding points.
After removing two irregular foreign objects, Lu Cheng said: “Teacher, I think it has been completely debrided. We can irrigate now.”
Lu Cheng did not act on instinct.
If he had followed his instinct, Lu Cheng would have thought that Professor Zhong Junyun wouldn’t use a patient as a test to check if he was careless.
But it wasn’t impossible. If he had started suturing immediately, the ulnar styloid process might have been affected.
“Mhm… you can…” Zhong Junyun nodded.
Lu Cheng then proceeded to repeatedly irrigate the wound with saline, hydrogen peroxide, diluted povidone-iodine, and saline.
After drying the wound with cotton pads again, Lu Cheng began to assess the blood vessel ends.
Brachial artery injury. The brachial artery is a medium-diameter artery, and its suturing is not difficult, nor does it require extremely strict suturing techniques.
After all, the thinner the vessel, the more difficult it is to suture.
After hesitating for a moment, Lu Cheng still said: “Teacher, I haven’t sutured a brachial artery before. Should I start suturing now?”
Zhong Junyun thought for a moment and said: “Then you can hand it over to Xiao Pan later.”
“Now remember an order: for limb replantation, as long as the patient’s injury duration is not long, it’s bone, tendon, vein, artery, nerve, skin.”
“Bone provides stability and the core framework, tendons are the vascular bed, and arteries and veins ensure limb survival.”
“If the ischemic time is longer, the order of arterial and venous suturing will take precedence over fracture fixation,” Zhong Junyun said, not scolding Lu Cheng, but teaching.
“Okay, Teacher.” Lu Cheng sniffled, feeling like he had fallen into a trap.
The main reason was that Professor Zhong Junyun had dug a pit within a pit, making it impossible for Lu Cheng, who did not specialize in hand surgery, to avoid it.
“Can you perform tendon suturing?” Zhong Junyun asked.
“Yes!” Lu Cheng replied.
“How do you plan to suture them?” Zhong Junyun continued.
“For the large muscle belly of the biceps brachii, simple interrupted suturing. For the coracobrachialis tendon, weave suturing. For the long head of the triceps brachii muscle belly, simple interrupted suturing…”
After answering, Lu Cheng added: “Actually, other suturing methods can also be used.”
“Mhm?” Zhong Junyun was initially quite satisfied with Lu Cheng’s answer, but upon hearing Lu Cheng go off on a tangent, he couldn’t help but hum.
“The tendon of the coracobrachialis is more suitable for a combined weave suturing technique,” Lu Cheng proposed.
“The name?” Zhong Junyun’s mind searched, Modified Tang Method? Tsuge? Tajima.
Lu Cheng swallowed and decided to say: “The teacher hasn’t named it yet.”
ps: An extra chapter update for 3000 monthly tickets, still asking for more!
