Chapter 162: Limb Replantation!
“October 1st, Thursday, Clinic Day Shift: Zhang Tiesheng, Clinic Night Shift: Tian Zhuang; Ward Day Shift: Du Daihua, Ward Night Shift: Han Xiaoping, Surgery Shift: Lu Cheng.”
“October 2nd, Friday, Clinic Day Shift: Zeng Huanqi, Clinic Night Shift: Zhang Tiesheng; Ward Day Shift: Tian Zhuang, Ward Night Shift: Du Daihua, Surgery Shift: Han Xiaoping.”
“……”
After Lu Cheng clearly saw the duty roster posted in the department group, he marked his shifts on the calendar.
Afterwards, Lu Cheng allocated all his skill points to Suturing Technique, entered the training room, grabbed a pitiful and adorable little hamster, and anesthetized it…
About an hour later, Lu Cheng completed the suturing of the anterior and posterior tibial artery of the amputated limb and sat on a stool in the training room in deep thought.
【Suturing Technique （Expert 15/200 ）（Skill Points -15）, Vascular Suturing （Proficient 8/10）（+2）, Nerve Suturing （Proficient 8/10）（+1）, Limb Replantation Surgery （Proficient 10/10）（Skill Points -4）】
【Current Skill Point Balance: 16.5 Points】
Lu Cheng glanced at the skill point income details on the panel again, fixed it in a table in his notebook, and filled in the following entry.
A: 0.3; B: 0.2; C: 4.8.
This was not Lu Cheng speaking in code, but Lu Cheng recording his skill point income details.
A represented teaching income, averaging 0.3 daily. B represented income from dawdling with medical orders in the ward, averaging 0.2. C represented Lu Cheng’s average daily surgery income.
It could be seen that the current teaching income had surpassed the income from dawdling with medical orders in the ward.
Daily skill point income was 5.3. According to the introductions from Professor Chen Song and Professor Tong Yuan’an, many experts at Xiangya Second Hospital could gain about 1 point of proficiency in twenty hours of practice…
Even if some geniuses gained 1 point of proficiency in ten hours or even five hours, he could still create a speed difference with them.
Lu Cheng’s mobile phone flickered. Lu Cheng picked up his phone and glanced at it. The message was from Mu Nanshu.
Mu Nanshu said they had already set off for Jishi City and had just reached the entrance of the highway toll station. Mu Nanshu sent a photo to Lu Cheng.
“Have a safe trip!~” Lu Cheng had already sent his shift schedule to Mu Nanshu.
The bitter life of a clinician is that holidays and festivals have nothing to do with doctors; duty shifts still have to be worked.
“We will be going on a trip to Xinjiang Province on the 2nd.”
“I’ll see if I can come back during the last two days of the National Day holiday then.”
Mu Nanshu said.
Lu Cheng smiled and replied, “Have fun!~”
During the seven days of the National Day holiday, Lu Cheng was on duty, his father still had to drive trucks, his mother had to set up a stall to sell vegetables, and Mu Nanshu’s whole family was going on a trip.
These were the different lives of different families; one couldn’t envy them.
After chatting with Mu Nanshu for a while, Lu Cheng received a call from Han Xiaoping, who was on the day shift in the ward.
“Han Ge…” Lu Cheng answered immediately.
“Brother Lu, we have a patient with a severed limb in the emergency department. The Orthopedics Department’s opinion is to transfer the patient or perform stump burial.”
“The patient was injured some time ago. He was transferred from Miaoshi Town. It might not be in time to transfer him to Zhou People’s Hospital at this hour.”
“What do you think?” Han Xiaoping immediately asked Lu Cheng for his opinion.
Long County wasn’t without cases of severed limbs and fingers, nor without cases where timely referral was impossible. However, the past handling method was to perform a “near-amputation” for stump burial.
If referral is too late, the illness still needs to be treated.
Limb replantation has a golden time for treatment; if this time is exceeded, referral is meaningless.
“I’ll come over to see the specific situation.”
“Han Ge, send me the amputation plane,” Lu Cheng said.
“What are the patient’s own wishes?” Lu Cheng asked.
Different amputation planes require different treatment methods.
For a completely severed limb, internal fixation of the fracture would also be required, which Lu Cheng did not have much practical experience handling.
However, Lu Cheng could also fill in the gaps by adding points.
“Of course, the patient and family are anxious. They are currently in a dilemma,” Han Xiaoping said.
“Then explain clearly to the patient. If they are willing to be transferred, immediately handle the stump hemostasis and transfer them. If they are willing to stay, let them choose between stump burial or attempting limb replantation.”
“It might not be successful, but there’s still a chance of saving it!~”
“By the way, Han Ge, which doctor is on duty in the Orthopedics Department today?”
Han Xiaoping glanced outside, lowered his voice, and said with a wavering tone: “Director Xiang is on duty.”
“Okay, got it.” Lu Cheng nodded.
……
Lu Cheng rode his electric scooter to the entrance of the Emergency Department, stopped, immediately jumped off, and quickly walked towards the Emergency Department while opening his phone to check the pictures Han Xiaoping sent.
The patient was a woodworking apprentice who had suffered a saw injury to his left forearm, resulting in amputation. He was not old, only in his teens.
After Lu Cheng put his phone away, he immediately rushed into the Emergency Department.
Director Lin Qianlong and Xiang Kuihua were communicating with the patient’s family. Lin Qianlong said at this moment, “If you want our hospital to guarantee survival, that’s impossible.”
“No matter where you go, no one can give you a guarantee.”
“Either you choose to be transferred, or you can follow Director Xiang’s opinion from the Orthopedics Department and have stump burial.”
The patient’s family member, likely his mother, was crying profusely at this moment: “Doctor, my son is still young. If he loses his hand, what will he do in the future?”
“There’s nothing we can do about that. Our hospital only has this kind of technique. We can try, but the chance of survival is not high, less than fifty percent.”
“You’ve already delayed for so long. Now the chance of survival is probably less than thirty percent.”
“If you still want to transfer him to Jishi City, and you delay for another two hours, there will basically be no chance of survival.”
“This is the reality, it’s not a simple fracture.”
“As you can see for yourself…”
“Director Xiang’s opinion is stump burial, which has a hundred percent success rate and can solve everything in one surgery.”
The young man was not very old, probably around sixteen or seventeen. His face was pale, his eyes were bloodshot and vacant, but he was not crying.
“Thirty percent, isn’t that too low?” The middle-aged woman’s expression was one of despair.
Lin Qianlong nodded: “It is a bit low, but it’s still a fact. You want us to guarantee success, it’s impossible!~”
“I can tell you absolutely now that it’s impossible to guarantee success, and the chance of failure is even greater!~”
“Make a choice quickly. Either transfer or have stump burial. Don’t delay any further,” Lin Qianlong urged.
“If you delay any longer, even the thirty percent chance might be gone.”
The woman’s phone rang at this moment. She answered it in a panic and relayed Lin Qianlong’s words.
A hurried and hoarse middle-aged male voice came from the other end: “Why is it so low?”
“The doctors here say they can’t do it,” the woman replied.
“It’s just that Xiao Dao is relatively young, otherwise, they wouldn’t want to take the gamble. The chance of failure is very high, and it’s basically impossible to perform such surgery in the county.”
“Then do it. What else can we do?”
“I knew I shouldn’t have let Xiao Dao learn carpentry. Go ahead and do it.”
“Xiao Dao, Dad is sorry to you.”
The young man called Xiao Dao finally became flustered, his voice cracking: “Dad, am I going to be useless…”
The patient had probably been to the health center in the town, so the severed hand was relatively well preserved, sealed with an ice pack.
As Lu Cheng approached, the woman nodded: “His father said to do the surgery, Director. But the money can only be paid later.”
“I came in a hurry and didn’t bring my card.”
Lin Qianlong said, “This isn’t about money right now. We’ll go into the operating room immediately.”
“Zhang Tiesheng, you are responsible for signing. Send the materials into the operating room later.”
“Director Xiang, would you mind helping with the consent discussion?” Lin Qianlong asked Xiang Kuihua.
Actually, the best person to have the discussion was Lu Cheng, but if Lu Cheng didn’t enter the operating room, the surgery couldn’t proceed.
Xiang Kuihua didn’t hesitate: “Okay, Director Lin, you guys go ahead. I’ll be over later.”
“You come with me. Your son’s condition is very critical. I won’t waste your time with unnecessary talk. The surgery needs to be done immediately.”
“The risks are as we’ve explained to you clearly…” Xiang Kuihua and Zhang Tiesheng went to the Emergency Department’s doctor’s office.
Lu Cheng and Lin Qianlong personally took the patient to the Emergency Operating Room.
After Lu Cheng took over the patient, Lin Qianlong immediately made several phone calls, naturally first to the on-duty supervisor, informing him about the surgery being performed without payment.
Then he called the Anesthesiology Department…
By the time Lu Cheng and Lin Qianlong arrived at the operating room, the Director of Anesthesiology, Hou Jiagui, had personally arrived.
The head nurse of the Emergency Operating Room and two scrub nurses and two circulating nurses had also arrived.
This was the first day of limb replantation surgery performed by their own hospital’s doctor as the chief surgeon. Neither Lin Qianlong nor the operating room staff dared to be careless.
The patient was anesthetized smoothly, and rapid general anesthesia was chosen.
Time was of the essence, so nerve block anesthesia was not to be wasted.
Lu Cheng and Lin Qianlong also quickly completed the disinfection and draping procedures.
Zeng Huanqi was also called to the operating room!
After putting on gowns and gloves, Lu Cheng said, “Director Lin, the injury time for this patient is quite special, so we need to reverse the standard surgical procedure. We will perform arterial and venous anastomosis first, and then internal fixation of the fracture.”
After speaking, Lu Cheng quickly instructed the circulating nurse and scrub nurse: “Heparin and saline, prepare plenty of both.”
“Also, get more syringes with needles.”
“It would be best to ask for a cardiologist to be on standby. For this severed limb patient, we also need to pay attention to reperfusion injury. Electrolyte imbalances may occur during the surgery,” Lu Cheng said to Hou Jiagui of the Anesthesiology Department.
“No problem, as long as your surgery department can handle it, we can manage these minor reperfusion issues,” Hou Jiagui replied confidently.
Previously, Tong Yuan’an from the Orthopedics Department had performed many limb and finger replantations and had gained considerable experience.
“Let’s start with debridement!~” Lu Cheng picked up the surgical knife and officially announced the start of the surgery.
The circulating nurse responded: “Time, 11:23:47 AM. Surgery begins. Limb replantation.”
Regardless of how long the time delay was, thorough debridement must be performed before vascular suturing. Otherwise, debridement after suturing would tear the sutured blood vessels, causing secondary damage.
Saw injuries would cause local vascular and nerve damage akin to rot, so necrotic tissue needed to be removed. Of course, all of this was within Lu Cheng’s expectations…
Long County, within Tian Yue Residential Area.
Peng Haibo received a call from someone in the operating room: “Director Peng, the Emergency Department operating room is performing limb replantation. Director Lin from the Emergency Department is leading the team.”
Peng Haibo was watching television and was startled by what he heard.
After a few seconds of silence, he said, “Director Lin has the ability to do that himself. He can handle it.”
“But, isn’t limb replantation a surgery for your Orthopedics Department?” the on-duty surgical nurse asked with some doubt.
“Professor Tong has already returned. Is it in accordance with regulations to carry out such surgery?”
Peng Haibo’s reply was rather official: “Whether it’s in accordance with regulations or not, Director Lin of the Emergency Department has his own considerations. In any case, our Orthopedics Department cannot perform such surgery.”
“Oh, okay, Director Peng. I was just reporting to you,” the on-duty nurse said and hung up the phone.
She only knew that the head nurse had personally gone to the Emergency Operating Room, but as she was the on-duty nurse today, if the surgery truly went wrong, she might also bear responsibility, which was why she asked.
Peng Kun was also at home. He had been watching television, but now he had no appetite for it.
Peng Kun glanced at Peng Haibo: “Lu Cheng? Is it true?”
Peng Haibo sighed and pulled his crossed legs down: “Don’t overthink it. Lu Cheng has clearly stated that he won’t stay in our hospital for long.”
“What you need to think about now is how to break through in the empty area of Hand Surgery within Orthopedics, and how to solidly learn the techniques.”
Peng Haibo then glanced at Peng Kun: “Also, don’t take what Xiang Kuihua and the others say to heart. These people are shrewd; they won’t open up to you.”
Peng Kun felt this deeply: “They don’t take you seriously at all.”
Peng Haibo sighed lightly: “Does it matter if they take me seriously or not?”
“My life is like this. I can’t learn anymore even if I try!~”
“At least for now, I still know a little more than they do. As long as no mistakes are made, even if they have other ideas, they can only keep them to themselves.”
“But this situation won’t last much longer.”
“I estimate, during the next director election. Forget it, let’s not talk about this.” Peng Haibo was also helpless.
He truly did not expect that after Lu Cheng and Xiang Kuihua had a clash, the fire would turn to him.
Xiang Kuihua went out to study and actually made such significant improvements. Of course, Luo Changwu and others also started going out frequently, which led to another significant change in the department’s current situation.
Peng Kun stood up after hearing these words: “I’ll go practice for a while longer…”
Ultimately, it was still his own lack of strength. If Peng Haibo were strong enough, or if he, Peng Kun, had Lu Cheng’s abilities, the department’s situation would not be like this.
Although Peng Kun’s backing was only Peng Haibo, as long as his ability was sufficient, Xiang Kuihua and the others’ backing could not influence Peng Kun.
Having no skills is the original sin!!~
