Great Doctor Ling Ran Chapter 242
242 Heavy Reinforcing Suture
After Ling Ran completed the two finger replantation surgeries he had arranged for the day, he changed out of his scrubs and left the operating area.
Confused and rattled, Lu Wenbin emulated Ling Ran and changed out of his scrubs too. After he returned to the office, he could not hold it in anymore and asked Ling Ran, "Are surgeries not fun for you anymore? Or do you feel some kind of discomfort? Are we really only operating on two patients today?"
Earlier, when he noticed how Ling Ran had only chosen two patients to operate on, he thought that Ling Ran just wanted to wait for more cases to arrive before he chose his next patients. He never thought that Ling Ran would even change out of his scrubs. When had Ling Ran ever taken off his scrubs before this?
"We need to use our wards a little sparingly." Ling Ran looked at Lu Wenbin and spoke in an experienced manner, "There are only around forty beds left, and even if we add extra beds, there'll be eighty beds at most. We can't operate on all the patients in one go anymore."
Huo Congjun happened to enter the office with his hands clasped behind his back at that moment. When he heard Ling Ran use the term "our wards", he got so emotional that his left hand could barely hold on to his right hand.
"Times are a little hard for us right now, but lately, I've been applying for additional beds for our department. There should be some news soon." Huo Congjun could not hold himself back from revealing some information. When the doctors in the office heard that, they started to discuss it.
Departments, hospitals, and the health system were very strict when it came to controlling the number of beds. In fact, the higher up the organization was in the medical system, the stricter the regulations were.
If Huo Congjun were to increase the number of beds right then, strictly speaking, all of them would be extra beds. However, because the Emergency Medicine building was huge and had its own wards, the department could make the extra beds look like ordinary hospital beds. He just needed to explain things to the hospital administration committee. Once he obtained their approval, the hospital would just assume that those extra beds were ordinary hospital beds during inspections. The only requirement from the hospital would be for the Emergency Department to limit the number of extra beds placed in the corridors and the wards.
However, for inspections by institutions of the healthcare system such as the provincial health office, all the extra beds had to be clear of patients. It was especially required when the Health and Welfare Committee sent its members for inspection. All the extra beds would not be recognized at that time. Otherwise, they would have to recognize the beds as ordinary beds, then request that the hospital increase its number of doctors and nurses.
Nevertheless, now that Huo Congjun wanted to build an Emergency Medicine Center, the addition of manpower and beds were a must. Or else, how could it be called a center if he was not even able to fulfill the basic criterion to build a center?
Ling Ran nodded in agreement and said, "There were one hundred and eighty beds in the Orthopedic and Sports Medicine Center. They added fifty to sixty beds, but it still won't be enough for the patient turnover rate. Our department still has room for development."
Next to him, Doctor Zhou was shocked when he heard that. Doctor Zhou could not even finish using up the five beds allocated to him every month. His average patient turnover rate was five to seven days, and that had already tired him very much.
Associate Department Director Du felt similarly uncomfortable. "Ling Ran, the departments in our hospital are already considered large if they have one hundred beds," he said with a smile.
"We already have almost one hundred now.
"I mean, without the extra beds.
"Won't the total number of beds reach two hundred if we add in the extra beds?
"How can you add so many extra beds to the point that it becomes double the number of beds we originally have?" Department Associate Director Du said, not knowing how to react anymore. "Ling Ran, think about it. You took up two beds today by carrying out two finger replantation surgeries. They'll stay here for forty days at most"
Huo Congjun coughed a few times and cut Department Associate Director Du off, preventing him from further embarrassing himself with his bad Math. He said, "We should encourage Ling Ran to desire more beds. When young people are willing to work, we shouldn't hold them back. Ling Ran, just focus on carrying out those surgeries well. You don't have to worry about other things. By the way, your research papers were pretty good. Keep working hard, and once you're done, go to the Finance Department for your reward."
"All right." Ling Ran agreed. He drank a few mouthfuls of water before he rose and said, "Doctor Lu, let's go to the treatment room."
"Okay." Lu Wenbin immediately followed Ling Ran.
Huo Congjun watched with a smile on his face as Ling Ran walked out of the door.
When Associate Department Director Du saw Huo Congjun's expression, he said in a soft voice, "You were terrified earlier, weren't you?"
"Huh No Hmm, a little bit." Huo Congjun exhaled.
"We've all seen Ling Ran carry out six or seven finger replantation surgeries in a day. Why would you even give him access to an unlimited number of beds? No one in our department has had access to an unlimited number of beds before" Department Associate Director Du said, similarly with fear in his heart.
"Didn't you hear what Ling Ran said just now?" Huo Congjun answered Department Associate Director Du's question with another question.
"Which part?" Department Associate Director Du asked, feeling confused.
Huo Congjun sighed in exasperation and said, "He kept saying 'our department' and 'we'. What does that mean?"
"It means that Ling Ran knows his grammar?"
"It means that Ling Ran sees our department as his home and takes pride in being a part of us." After Huo Congjun corrected Department Associate Director Du, he continued, "You mentioned access to an unlimited number of beds. We are the Emergency Department. Have you ever needed access to an unlimited number of beds before this? Have I?"
Department Associate Director Du went silent.
There was one good thing about the Emergency Department; they could transfer patients to other departments.
Of course, that was if the other departments were willing to take in those patients.
Under ordinary circumstances, patients resuscitated by Huo Congjun and the others would be allocated to certain departments. The departments themselves would send people to collect those patients. Only a small minority of patients, such as those with diarrhea, stomach pain, headaches, and those who vomited non-stop would be retained in the Emergency Department's observation room for monitoring purposes, as they did not have a definite diagnosis.
However, once Ling Ran started to snatch the Hand Surgery Department's business, unless Huo Congjun transferred all the surgery fees into the Hand Surgery Department's account, it was impossible to ask the Hand Surgery Department to take in Ling Ran's patients.
In other words, a larger Emergency Department needed its own hospital bedsa lot of them.
Department Associate Director Du could not help but sigh again. "If Ling Ran were to go crazy with the surgeries again, no matter how many hospital beds we add, it wouldn't be enough."
"We'll talk about it when that happens. Every problem has a solution." When Huo Congjun realized that the doctors around him were listening to him, he spoke by emphasizing each word, "No hospital is afraid of having too many patients. Along with insurance payments, we receive more than 20,000 RMB from each patient who undergoes finger replantation surgery. How else do you think I've been able to negotiate for my way in the hospital administration meetings?"
Department Associate Director Du immediately lowered his head.
A department could rely solely on its department director's ability to argue his way through the hospital administration to grow, but even if he were to argue his way through, he needed facts to back him up. In the past, the Emergency Department grew by relying on its famed Trauma and Burn Surgery Department, the fact that Yun Hua Hospital itself was renowned, and the areas of responsibility that Huo Congjun snatched from Beijing Emergency Medical Center using his influence as well as ability to argue with others. With the addition of the finger replantation surgery and the M-Tang surgery program this year, even associate chief physicians found their lives improving. It was obviously not the right time for Department Associate Director Du to continue saying anything.
When he thought about it, did the hospital not try all means to hire experienced doctors just to carry out more surgeries, gain a higher occupancy rate in the medical world, and increase its influence?
Ordinary attending physicians would complain of fatigue after they carried out an average of twenty to thirty surgeries every month. Meanwhile, Ling Ran could perform thirty to forty major microsurgeries in a week. With his efficiency, Huo Congjun certainly had the right to ask for access to an unlimited number of hospital beds.
Without those hospital beds, they would not be able to bring in those patients. They would be deliberately chasing patients away instead.
While the people in the office debated the issue, Lu Wenbin was at a loss for words when he found out that Ling Ran aimed to carry out debridement and suturing after he followed Ling Ran to the treatment room.
"Doctor Ling, isn't it bad for us to snatch tasks from the medical interns at this point in time?" When he saw the covetous gazes of the doctors around him, Lu Wenbin felt his face burn in embarrassment. He was already a resident doctor, and by next year, he would be a senior resident doctor. In other words, he had already been in the hospital for about five years. He was even a resident doctor who had served as the first assistant in M-Tang surgeries, finger replantation surgeries, and Achilles tendon repair surgeries. He could be considered a respectable and rising figure among the newbies.
When Lu Wenbin stood in front of medical interns and housemen or similarly young resident doctors who had never participated in surgeries, he felt an extremely strong psychological advantage.
That was especially true after he traveled to Shanghai, was trained by the academician, witnessed China's top orthopedic technology, and participated in a star athlete's operation. Liu Weichen really did not have the heart to scramble to perform debridement as well as suturing, and snatch the young doctor's tasks in the treatment room.
Ling Ran only gave Lu Wenbin a strange look. "I'm an intern too."
"You" Lu Wenbin was speechless as he looked at Ling Ran's handsome face.
"We'll sit in Cubicle Two. Please find us someone with a larger wound." Ling Ran greeted the nurse on duty in the treatment room. He then proceeded to sit down in a small cubicle, which happened to be empty, and drew the curtains.
Lu Wenbin tiptoed into the cubicle hesitantly.
He was a resident doctor, and his name would be in the list of those who performed debridement and suturing that day.
Lu Wenbin felt extremely guilty about it.
Soon, a patient in a wheelchair with a wound on his thigh was pushed into the cubicle.
"What's your name? How old are you?" Lu Wenbin habitually picked up a pen and paper before he started to write down the patient's medical record.
As Lu Wenbin asked questions, Ling Ran enlisted the family members' help to carry the patient to the treatment bed. Ling Ran then examined the patient's wound and contemplated in silence.
"Can you ask a nurse to come in?" Ling Ran asked when he noticed that Lu Wenbin was done with the medical record.
Lu Wenbin threw Ling Ran a puzzled glance and went out to get a nurse.
Ordinary debridement and suturing could either be carried out by a doctor and a nurse or alone by one poor doctor. Now that there were two doctors present, Lu Wenbin did not understand why Ling Ran wanted a nurse to come.
However, it was very easy to ask for nurses on Ling Ran's behalf, as nurses would rush over to his side the moment they learned that Ling Ran had asked for them. It was not much trouble for Lu Wenbin.
Soon, two nurses arrived at the same time.
As Lu Wenbin stepped aside to let the nurses take his position, his mind was filled with thoughts of abstract concepts like how "this world was unfair".
"The area of the wound is relatively big, and there's minor skin deficit. I plan to do a buried subcuticular heavy reinforcing suture. That way, the scar will be smaller after the wound heals. I want to use a 2-0 strong absorbable suture. Do you have it?" Ling Ran explained to the patient and the patient's family members while he raised the question to the nurses according to the manual of emergency medicine.
The patient as well as his family members looked at one another and reluctantly agreed after they asked for the price.
The two nurses went to retrieve the surgical thread with strange expressions on their faces. They attached the thread to a needle and passed it to Ling Ran. Right after Ling Ran finished debriding the wound and suturing the internal layer of the wound, he poked the needle through one side of the wound...
Lu Wenbin was extremely surprised. He could not help but say, "Doctor Ling, the wound is three inches long. Are you using the subcuticular suture technique?"
The patient's wound was on his thigh. Even though the appearance of the scar would definitely be nicer with the use of the subcuticular suture technique, the stitches of wounds sutured using the subcuticular suture technique were inferior in strength compared with those sutured using other techniques. As the wound was three inches long, the suture could break only after a few days. If that happened, the patient would be left with a really ugly scar.
Ling Ran could tell what Lu Wenbin was thinking. "This is a heavy reinforcing suture," he said.
The heavy reinforcing suture technique reduced the tension of the stitches. Tension was the main reason why sutured skin split.
When he spoke, Ling Ran had already inserted his needle into the patient's dermis. After he made four continuous stitches, he made a knot on the outer surface of the patient's skin, in the position where he first inserted the needle. He then repeated the process three times and put down the 2-0 surgical thread. "Can you pass me the 5-0 suture with conventional cutting?" he asked the nurses.
Lu Wenbin suddenly realized that Ling Ran was already done with the heavy reinforcing suture. In other words, Ling Ran had already pulled the split skin together in just twelve stitches.
"Was the skin's tension distributed to the dermis and fascia?" Lu Wenbin asked in a semi-enquiring tone.
"Hmm, even though the wound's three inches long, after we distribute the tension, we can suture it without worrying about said tension," Ling Ran explained and continued with the task at hand.
The two young nurses did not quite understand what was going on, but they gasped simultaneously in admiration. "Doctor Ling, you're amazing!"
Lu Wenbin felt a little that the world was now a little more fair to him. Even though they had just carried out a debridement and suture surgery, the fact that it was done in such a classy way made him feel less embarrassed.