Great Doctor Ling Ran Chapter 243
243 The Scarless Girl
The heavy reinforcing suture technique took a much longer time compared to ordinary suturing techniques.
First, the skin's tension had to be distributed using the 2-0 surgical thread. This part of the suturing process needed to be done in segments, and for every segment, you had to pay attention to the exact point of insertion and exit of the needle. And this had to be decided by taking the tension of the skin and the gap between the stitches into consideration. Aside from that, each stitch had to be made between the fascia and the dermis.
In addition, it was also very difficult to align both sides of the torn skin. Injured skin was not always even, and there might even be situations where there was a deficit of skin. This made alignment even more difficult.
However, if both sides of the torn skin were not aligned, there was no point in using the heavy reinforcing suture technique. If the end product were stitches that resulted in wrinkly skin, it would have been better to use ordinary techniques such as the simple interrupted suture or the simple continuous suture technique.
In cases where the debridement process was uncomplicated and did not take long, young doctors in the Emergency Department only required around ten minutes to suture wounds that were a few inches long using ordinary suturing techniques. This timeframe even included all the talking, examination, and documentation that needed to be done before and after the suturing.
The suturing time for the buried subcuticular heavy reinforcing suture technique Ling Ran used took more than thirty minutes. After being in the treatment room for two hours, he had only treated three patients.
Very soon, the attention of the medical interns in the treatment room moved away from Ling Ran.
Yun Hua Hospital's Emergency Department was very large, and they could still afford to let Ling Ran carry out three cases of debridement and suturing for two hours.
Doctor Zhou walked around the treatment room. After a while, he arranged for a little girl to come over.
The little girl's wound was in the area of her tibia, which was at the front of her lower leg. The wound was S-shaped, and it was almost two inches long. It was considered a large wound.
Beside her, her parents' thoughts ran wild. Her father had an anxious expression and looked worn out. He probably rushed to the hospital with her. Her mother's fingernails were painted in bright colors, and she gestured non-stop as she spoke, "I have always told you to be careful, to be careful. Why are you so careless? See, because of you, your father and I can't even go to work, and had to rush to the hospital. All hospitals nowadays only care about money. Cosmetic surgery? Why don't you guys just say that you're robbers?"
As Ling Ran examined the little girl's wound, the little girl's mother scolded people continuously. She spent the most time scolding the little girl, while the hospital and her husband came next. At the same time, she did not forget to scold her bosses and colleagues...
Ling Ran acted as though he did not hear it.
When it came to the things other people said, if they were not spoken to him specifically, Ling Ran often pretended that he did not hear them.
Ever since he was little, there had always been people who deliberately voiced their opinions loudly, discussed certain things, or raised certain rumors beside him. If Ling Ran were to pay attention to all of them, he would not be able to enjoy a quiet moment for a very long time.
Ling Ran's experience taught him that he must decide whether he wanted to ignore certain people, as quickly as possible.
For example, the little girl's mother. Even though she was the patient's direct family member, and she was emotional right now with a mixture of anger, fear, worry and sorrow, the words she said were meaningless, and were only a means for her to vent her emotions. The information contained in her words were ineffective, and even wrong.
The first thing Ling Ran did was to make his judgment on the state of the injury, with how the world would perceive the injury as his basis.
The good news was that her bone was not injured. However, to further consolidate his judgment, Ling Ran still raised his head and asked, "Are there any X-ray scans?"
"X-ray scans, your a*s." The little girl's mother's head was raised ever since she entered the cubicle. At this moment, she stared at the top of Ling Ran's head and scolded him furiously, "The doctors I encountered in the past can know whether a bone is damaged just by touching it. If Yun Hua Hospital wasn't near my house, I wouldn't have sent my daughter here even if I was crazy. Can't you guys find someone reliable? Where are your chief physicians? Can't we register to see a specialist?"
A little embarrassed, Doctor Zhou went to stand in front of Ling Ran and said in a soft voice, "The patient's family members are opposed to doing an X-ray. If you can"
"Then, let's go straight to debridement and suturing." Ling Ran was no longer a fledgling and had seen situations like this more than once in the Emergency Department.
The hospital itself was a miniature world that reflected reality. Here, there were people who would request for VIP consultation just so that they would not need to queue up. There were also people who would skip having their X-rays taken just so that they could spend 100 RMB less.
The purpose of having a patient's X-ray taken was to make sure that the diagnosis was flawless. In other words, the patient would be exposed to risk if the X-ray was not taken.
Fortunately in this case, the risk was not too big. Ling Ran adjusted his sitting position a few times. He then rose and took a deep breath before he sat down again to examine the patient.
The little girl's mother stared at Ling Ran for a few seconds before shifting her gaze away. Even though her tone was no longer as harsh as before, she said, "Young people really shouldn't be trusted with important tasks. Hospitals nowadays are really horrible. The clinics I visited in the past were much better"
"I'll carry out the debridement while you administer local anesthetics," Ling Ran ordered Lu Wenbin. He then lowered his head and started with the task at hand.
Lu Wenbin coughed a few times and said, "For the patient's family members, please leave the cubicle."
"I'm not leaving. What if you guys mess things up after I leave?" The little girl's mother stiffened her neck and grabbed the handrail beside her, which was supposed to assist patients when they moved. She was prepared to solve matters with violence.
None of the doctors and nurses wanted to get involved in this. All of them lowered their heads and pretended that they did not see it.
Her father said in slight embarrassment, "I'll go wait outside."
"Hmph, you worthless coward. You want to play the role of the good person now? Where the hell were you earlier?" The woman's voice immediately became shrill.
The little girl began to sob. Ling Ran could only stop the debridement, and he only continued when the girl's trembling body became a little steadier.
The woman was somewhat tired, too. She stopped gesturing with her handswhich had colorful fingernailsand asked, "Will there be a scar?"
Doctor Zhou glanced at Ling Ran with an apologetic expression. He then said to the woman, "If you go to the Department of Plastic Surgery"
The woman raised her voice once more. "I've already told you just now that I'm not going to that place to let them rip me off"
"I'm saying that!" Doctor Zhou raised his voice a little as well and said, "I'm saying that even if you go to the Department of Plastic Surgery and let them charge you 2,000 to 3,000 RMB for every 0.4 inch of the wound they suture, they still won't be able to guarantee that there will not be any scarring."
"See? Then why the hell did you ask me to go to that place"
"There is a possibility that there will be a scar when you have your wound sutured at the Emergency Department." Doctor Zhou glanced at the little girl who lay on the treatment bed and lowered his voice a little. "However, Doctor Ling is very skilled. He used the buried heavy reinforcing technique on his patients just now, and it is a technique that reduces scarring. It is also the same technique used in the Department of Plastic Surgery."
There was a glimmer of hope in the little girl's eyes as she looked at Ling Ran.
Because the wound was on the frontal side of her lower leg, she would no longer look good in dresses in the future if there was to be a scar left there. She at least did not want it to be a large, black scar.
Ling Ran glanced at Doctor Zhou and said, "Subcuticular suture techniques require absorbable surgical thread.
According to the hospital's charges, absorbable sutures were much more expensive than ordinary surgical threads. Besides, if the threads were imported goods, they could not claim their medical insurance as well.
Doctor Zhou nodded and said, "We'll talk about that later."
The departments always had to bear the losses when it came to surgical threads. However, because Doctor Zhou was an attending physician, he could always do things such as fake the accounts as long as the nurses on duty agreed to it.
The nurse beside them immediately went to retrieve a box of absorbable sutures without saying anything.
Ling Ran lowered his head and continued to debride the little girl's wound. At the same time, he explained to the little girl, "After the anesthetic is injected, I'll first align both sides of your wound and use the buried heavy reinforcing suture technique to stitch them together. 'Buried' means that the stitches will not be visible on the surface."
The little girl held her breath as she listened and asked, "Since the stitches won't be visible, there won't be a scar, right?"
She was talking faster than usual now. It was obvious that she was usually a lively little girl, but held herself back immensely before her mother.
Ling Ran contemplated for a moment and told the truth, "Scars are not formed because of the stitches. However, the heavy reinforcing suture technique can indeed reduce the formation of scars.
"So, there will still be a scar?" The little girl quickly understood what Ling Ran said.
Ling Ran nodded. "If the recovery goes well, the scar will be smaller. But there is still the possibility of a scar."
"What what if I go to the Department of Plastic Surgery?" The little girl glanced tentatively at her mother.
Ling Ran said without hesitation, "There might still be a scar."
Disappointed yet relieved, the little girl hummed in acknowledgement.
"After using the buried heavy reinforcing suture technique, I'll use the subcuticular suture technique. Similarly, the stitches will not be visible. But with the subcuticular suture technique, the stitches' strength will be relatively weak. So, you will have to pay extra attention and follow all the doctor's orders to reduce scar formation.
"Then, if I follow all of the doctor's orders, how big will my scar be?" The little girl timidly raised her fingers and gestured. She then reduced the gaps between her two fingers a little and asked, "Will it be this big?"
"It might be a little smaller."
"It might be even smaller."
"It's possible. Do you know what 'possible' means?"
"I know. You don't dare to give me an exact answer because you're afraid that my mother would scold you." The little girl was similarly very rich in life experiences.
Ling Ran started laughing. His pitch-dark irises sparkled under the sunlight.