Great Doctor Ling Ran Chapter 523
524 Ectopic Implantation
"Okay then. Take out your Kirschner needle and let me have a look." Ling Ran checked the Kirschner needle in Huang Maoshi's box. He nodded and asked, "Is it free?"
"Yes. We have a portion of needles from the manufacturers to promote" Huang Maoshi quickly briefed Ling Ran of the situation.
Ling Ran selected some of the commonly used types and nodded to Nurse Liu before he said, "Please clean and disinfect them. We'll be using them as a backup later."
"Okay." Nurse Liu waved her hand in a familiar motion and left with Huang Maoshi.
The medical staff in the hospital had long since become familiar with the existence of pharmaceutical sales representatives. Pharmaceutical sales representatives would also move about in the operating theaters.
This was especially so when doctors needed to use medical consumables that the hospital seldom used. The hospital or doctors would then order through phone calls, and they would be sent by pharmaceutical sales representatives.
Hospitals that were below tertiary Grade A hospitals found pharmaceutical sales representatives with suitcases like portable medical consumables. The hospitals themselves could not build medical consumable storehouses or had small medical consumables storehouses, hence, this was how they got their supplies. Usually, the pharmaceutical sales representatives were notified a couple of days earlier, and the pharmaceutical sales representatives would send the medical consumables the next day. The nurses would then clean them and send them to the operating tables.
However, the cheap Kirschner needles were only around 100 RMB, and the expensive ones were about 800 to 1,000 RMB. Usually, they were only available in a hospital's medical consumables storehouses.
Pharmaceutical sales representatives were also too lazy to deliver them.
Of course, just like how there were actually doctors who did not mind performing drapings, there were always exceptions.
Pharmaceutical sales representatives were now trying to get close to Ling Ran. Forget Kirschner needles, they would even bring pinheads to the operating theaters just so they could get see Ling Ran's face. Huang Maoshi was also very content to endure this hardship.
When it was around the time for surgery, the patient was pushed in.
Su Jiafu first stood up to do various check-ups before he administered anesthesia.
Lu Wenbin, Yu Yuan, and the others busied themselves with the draping.
Ling Ran leaned over to examine and assess the patient's wound.
Suturing four severed fingers were already difficult, and worse still, these fingers were severed because of the explosion from firecrackers. It was considered as a complex injury among hand-related injuries. Suturing them was also very difficult.
The most difficult part was that the small patient's fingers now had defects in his skin and arteries.
As Ling Ran was examining and pondering about it, he took the X-ray scan that has just been taken a while ago.
After examining it for a while, Ling Ran shook his head and said, "Give Chief Physician Wang Haiyang a call. You can't treat these fingers, the blood vessels are too thin. Hmm... wemight need to give up on the index finger."
In medical terms, the index finger was the second finger, and this time, it was the finger that suffered from the most severe injuries from the firecrackers. Not only had the bone shattered, the skin in the middle and the tendons were also largely torn and burnt. While they performed debridement later, they might need to remove those parts.
Lu Wenbin and Ma Yanlin were disappointed. The two of them had followed Ling Ran for the longest time and performed the most finger replantations. If two chief surgeons were required for this surgery today, both of them would have the opportunity to be chief surgeons.
However, the blood vessels of the fingers had always been thin, and they were even more so when they were on children. The wounds by the firecrackers were so complicated that neither Lu Wenbin nor Ma Yanlin had the confidence to handle it.
"Call the interns over as well." Ling Ran gave them another instruction before he returned to look back at the scan.
A huge difference between a chief surgeon and the assistants was that the chief surgeon determined the flow of the surgery.
In every successful surgery, the chief surgeon must be familiar with everything before he or she started the surgery. He must have every step properly thought out, and those who were better will even think about how to handle every accident conceivable.
Of course, when the same procedure had been performed multiple times, thought about how they wanted to handle accidents many times, and also had many experiences in handling accidents, they could cut down many of the preoperative steps. However, looking at medical imaging scans was something that could not be dismissed.
"There's no MRI scan?" Ling Ran asked the people at the operating table.
Yu Yuan said, "They're cleaning the MRI scanner now"
None of the departments could escape from having their facilities receiving a deep clean with the explosion of the MRSA infection.
Ling Ran said in resignation, "Alright then, we can basically tell what his condition is through the X-ray scan. How long will it take for Chief Physician Wang Haiyang to arrive?"
"Then, we'll wait for a while. Have the forms been signed?"
"Both have been signed. The child's parents are divorced. The mother is not in Yun Hua City. His father and aunt signed it." Yu Yuan briefly explained, but she did so meticulously.
Ling Ran nodded and continued to look at the patient's wounds.
Lu Wenbin opened the draping to look at the patient's face. He said, "This brat is only about eight or nine years old."
"Seven or eight years old? There's a reason why even dogs don't like a child at this age," Zuo Cidian said, "When we were in the town hospital, the injuries suffered by these brats are the most amazing ones when we performed the emergency treatment. I have encountered those who got hospitalized by eating diarrhea and tasting feces"
"Why would anyone taste feces?" Yu Yuan was in disbelief.
"Guess what the brat said? He said his family always says dogs' feces are stinky, so he wanted to give it a try just to know whether it's true."
Everyone in the room was fascinated.
Yu Yuan laughed so much that she almost could not catch her breath. "Of course it's stinky. Everyone knows that just by smelling it. We smell something stinky, not taste it."
"How would a small child know? I have to say, what our noses smell might be different from what we taste. It would be a more direct way to know if we just taste it, just like durian, right?" Zuo Cidian suddenly had a surge of faint nostalgia. Even though he had never liked the town hospital, he did spend his youth there.
Lu Wenbin felt puzzled. "Even if he ate feces, he didn't have to go to the hospital. Do town hospitals take care of situations like this as well?"
"Oh, the brat was bitten by the dog when he tried to taste its feces." Zuo Cidian gave a reasonable answer. Find authorized novels in Webnovelfaster updates, better experiencePlease click www.webnovel.com for visiting.
Yu Yuan asked in puzzlement, "Did his family tell him to taste the feces while it's fresh?"
Zuo Cidian was stunned for a moment before he said, "Most probably. The brat already ate the feces. Who cares if he ate them fresh?"
The airtight access door was opened, and Chief Physician Wang Haiyang rushed in.
"You're all here?" Wang Haiyang grinned. He had his hands raised up to let the nurse help him wear his surgical gown.
"Injured by firecrackers. Eight-year-old child. Four fingers severed" Zuo Cidian quickly stepped forward and began to introduce the situation.
Wang Haiyang and Ling Ran operated with a similar approachboth looked at the scans before they looked at the hands.
"I don't think we can fix the index finger." Wang Haiyang's judgment was similar to Ling Ran's, and his decision was firmer than Ling Ran's.
The brat's homemade firecracker was quite powerful, and it had basically exploded in his hand. So, the injuries to his bones, tendons, and blood vessels were very serious. The index finger was the first to be affected by the blast, so it was injured the most severely.
Ling Ran nodded and said, "We can try to replant it, but it will be more difficult to achieve excellence."
If they could not make it reach excellence, then they would have only be considered to have replanted the finger but did nothing to ensure that hand functionality could be retained.
Of course, they would have already been considered to have done quite a good job if they could even be able to replant it.
At the very least, the child will not have strangers staring at his hand.
Wang Haiyang looked at it carefully and said, "Ling Ran, this injury is enough to meet the standards for ectopic transplantation. Do you want to perform ectopic transplantation for the index finger?"
His suggestion instantly attracted Ling Ran.
Ectopic transplantation on a finger meant that the finger would first be transplanted to other parts of the body, and when the wound healed, it would be re-transplanted to the hand.
Transplants usually only happened nice, but this was a two-time transplant, hence,the final result would definitely not be as good as a one-time transplant.
However, if a finger that had insufficient replantation conditions had the chance for a second replantation in the future, it was good.
Ling Ran quickly thought for a few seconds before he said, "I don't know how to do that."
"Huh, you don't know how to do that?" Wang Haiyang felt happy for a moment and looked at Ling Ran. He almost yelled, "Let me teach you, let me teach you."
Ling Ran nodded, "I have never learned ectopic transplantation before."
His Perfect Level Finger Replantation Skill was limited to finger joints. Ectopic transplantation could be seen as another specialized skill, and it was not only limited to the fingers, but could also be performed on the arms, calves, ears, and so on.
"The doctors of the general Orthopedics Department or the Hand Surgery Department don't learn ectopic transplantation. Now, it's impossible for those private hospitals to engage in this kind of project as well." Chief Physician Wang Haiyang laughed a couple of times and sad, "But I know. Why don't we perform ectopic transplantation for this index finger today? I will give you on-the-spot teaching. After a few weeks, let's do the second-stage replantation."
Being able to teach Ling Ran made Wang Haiyang extremely happy.
This was the secret behind why the Hand Surgery Department of Yun Hua Hospital was the elite department. In other hospitals, ectopic transplantation would have already been used as publicity material to promote the hospital for ten years.
At Yun Hua Hospital, ectopic transplantation of a finger could only be regarded as something basic. They had to do a few cases of ectopic transplantation every year.
Being able to learn new things made Ling Ran feel a little excited.
He then looked at the little patient's index finger and said, "Inform the patient's family and ask them whether they're willing. We will perform replantation on the other three fingers first. Doctor Zuo, you can go ask them."
"Noted." Zuo Cidian immediately agreed. He took off his surgical gown and was about to leave when Wang Haiyang Wang Haiyang called out to Zuo Cidian so that he stopped.
He said, "You can give them around a 40% discount. Go to your Department Director Huo, he will definitely approve it. Ling Ran, call Department Director Huo. Hospital bills for ectopic transplantation are much more expensive than a replantation. Moreover, during finger implantation, a lot of attention needs to be paid in regard to nursing care as well. But you tell them clearly that the current situation of the index finger of the child that I suggest that they perform an amputation if we don't use ectopic transplantation. The possibility of forcing a replantation and the finger dying is very high. In addition, ectopic transplantation can preserve the finger's shape better."
Zuo Cidian noted it down. When he went out of the operating theater again, he was no longer as fast as before.
This kind of conversation could be quite difficult.