Chapter 707: You’re Not Good Enough
“Chief Sun, for similar surgeries, the purpose of the intervention is to open up the blood vessels. Is there any other use?” Xie Ning asked.
“Uncle Ning, it’s already very impressive that you can open up the blood vessels, especially for this kind of critical and external injury thrombus. Wherever it is opened up, the limb… Up to five to ten centimeters of the limb can be preserved,” Chief Sun explained. “However, the operation to remove the thrombus through intervention is very difficult. For a thrombus that lasts for more than six hours, removing it is especially difficult. I don’t really understand the specifics since I don’t do interventional surgery.”
Xie Ning nodded and did not say anything. He looked at Zheng Ren in the operating room as he began the operation. He was deep in thought.
Soon, the screen in the operating room lit up.
The guide wire extended along the femoral artery but did not go far. The catheter was also in place. The moment the screen lit up, the angiogram had already begun.
The contrast agent did not go far before it was blocked. The blood vessels below one-third of the injured person’s thigh were severely occluded and blank. This meant that blood clots were continuously forming and had spread from below the knee joint to one-third of the thigh.
Ischemia, oozing, and edema caused the injured person’s limb condition to continue to deteriorate.
In the past two days, there were too many similar injuries. Chief Sun was already numb.
If he had invested even a little emotion, the doctors would have already broken down emotionally and more people would not be able to get treatment.
Right now, all the doctors were only focused on the patient’s condition and did not think about anything else.
To be able to come down from the front alive was already a blessing in disguise.
On the screen, the surgeon did not stop stepping on the line after the angiogram was completed. Instead, he took out a normal catheter, took out the embolic catheter, and immediately went in.
When it came to the key point of the surgery, Chief Sun knew.
The embolic formation had already been at least six hours, or even 36 to 72 hours. It was not considered a fresh blood clot and was extremely difficult to take it out.
However, since the pract.i.tioner insisted on doing it, he should be able to remove a section of the embolus. Chief Sun was confident.
Under the current situation, people who were not at the same level would definitely not dare to waste time trying again and again. The mountain of injured people outside was a huge pressure in itself.
Under such circ.u.mstances, it was not the time to show off. Doing what he could was key to the situation.
“Eh? Uncle Ning? Aren’t you busy on your end? How come you have time to come over?” Su Yun’s voice came from the door of the operating room.
“Su Yun, I’m here to take a look at the situation on this side. I know what I’m doing. Are you alright over there?” Xie Ning smiled and said, “Your surgery was done very quickly.”
“It’s the boss’s surgery that was done quickly. It has nothing to do with me.” Su Yun said, “Mu Tao can only complete one in forty minutes. It’s as slow as an ox pulling a cart.”
When Su Yun talked about Mu Tao, he did not feel any pressure at all. It was as if it had nothing to do with him at all.
Uh… Chief Sun was stunned.
Interventional surgery for a severe pelvic fracture in forty minutes? He was already so fast that he practically ‘flying’, right?
How did he become so slow that he was pulling a cart with an ox?
He tilted his head and glanced at the person who walked in. It was a handsome young man.
He was really arrogant. Did all young people nowadays talk like that? When it came to emergency treatment, were they not serious at all?
Perhaps, this was the style of operating? It was possible. In the operating theater of every hospital, the atmosphere of chatting was different. In short, the simpler and easier it was, the better. But what kind of doctor was this? Why was he so indecent?
“He’s pretty good,” Xie Ning said with a smile.
“Chief Jiang, what is the boss doing?” Su Yun asked.
“Thrombectomy,” Chief Jiang answered.
“Oh, has he slept for a while?” Su Yun asked.
“He just slept for about ten minutes.”
“He should just go on. Sooner or later, he will tire himself to death,” Su Yun scolded.
The few people standing in front of the operating table felt gloomy. They had been busy with the surgery for at least thirty-six hours. Su Yun was telling the truth when he was transporting the seriously injured people across the mountains.
But what could they do?
There were still more than ten seriously injured people waiting to be amputated outside. If the embolectomy was successful, it meant that the limb would be preserved for as long as possible.
Chief Sun was stunned for a moment and sighed in his heart. When he looked back at the screen, he was surprised to find that the embolectomy catheter was no longer in the femoral artery.
Was it a mistake in the operation? It had to be.
It was inevitable for him to make mistakes when he was so sleepy. It was not a big deal.
But…the image seemed to be different.
He looked carefully and found that a part of the femoral artery in his thigh seemed to have opened up. The remaining contrast agent was spreading at a visible speed in the capillary branches next to it.
This meant that the blood supply had not been lost for a long time and the capillary vessels had not completely blocked up. Once the femoral artery was opened and blood flowed down, the arterial pressure would open up the capillary network again.
He had just spoken to the other for a bit, and the surgeon had already removed a section of the embolus?
This speed…was too fast.
However, Chief Sun was not surprised. The surgery had just begun and the femoral artery could be said to be full of blood clots. Only one section was removed and it would not be of much help to the overall condition of the patient and the subsequent surgery.
As for the specifics, he would have to see it again.
“From the Orthopedics Department?” Su Yun walked over, looked askance at Chief Sun, and asked.
Uh… His tone was very unfriendly. Chief Sun was surprised. He did not seem to have offended this person. Why was he speaking to him in such a tone?
He was a little absent-minded but it was not worth arguing over such a small matter. Everyone was quite angry and Chief Sun knew that. He nodded and said, “Yes, I’m the Chief Resident of the Orthopedics Department of Chengdu Provincial Hospital.”
“Chief Resident, is your Department Chief here?” Su Yun asked in a lazy voice.
“The chief is staying at home. I was called to the emergency department as soon as there was an accident.” Chief Sun was getting more and more annoyed with this man so he just gave him a perfunctory answer.
“Then you might not be able to perform the surgery…” Su Yun stretched his tone, and then seemed to be deep in thought.
“I’ve done it before. I’ll definitely be able to do it.” No matter how good Chief Sun’s temper was, he could not hold it in anymore, so he answered Su Yun coldly.
“Hehe.” Su Yun chuckled. “Looking at the contrast, the crush injury should be about five to six centimeters below the knee joint. The distance is especially short. Are you confident that you can save the knee joint?”
“Uh…” Chief Sun hesitated for a moment. In his opinion, the knee joint would definitely not be able to be saved. The efforts of the surgeon who was undergoing the surgery were to open up the blood vessels as much as possible so that the osteofascial compartment syndrome would be lighter and the healing speed would be faster. The patient would also lose less of their thigh.
“Also, I think the boss was saying that we should not use a tourniquet when we amputate the leg,” Su Yun muttered as he narrowed his eyes and looked at the screen.
Even he himself did not believe what he said. However, Zheng Ren spent a lot of effort to remove the clot and open up the artery. Under normal circ.u.mstances, it would take at least 12 hours for the operation to be carried out after all the capillaries had been opened.
This was a special case during a special period.
Usually, it was rare for a patient to be squeezed by a heavy object for more than an hour. But now, an hour was considered a fresh injury. Most people would be underneath a heavy object for about one to two days, making the injury serious and necrotic.
At this time, the capillaries were opened and the necrotic tissue would be absorbed into the blood, causing serious complications such as bacteremia, acute kidney failure, and so on.
Therefore, they absolutely could not wait for 12 hours before amputation. Instead, they had to seize the time. It was best to start amputation immediately after opening the blood vessels and remove the necrotic tissue so as to minimize the possibility of complications.
Chief Sun was stunned. There was no need for a tourniquet for amputation? What about bleeding? That was the femoral artery. After it was cut open, blood would flow like a river.
“So, you’re useless since you can’t see it. Go and find someone with a higher standard.” Su Yun crossed his arms and looked at the operation on the screen. He praised, “The boss is becoming more and more proficient in this surgery. It’s really amazing.”
The tone of his praise for Zheng Ren was completely different from the tone he used to speak to Chief Sun. It was as if he was a completely different person.
Sun Zhenxing was stunned. This person really flipped his face faster than flipping through a book. Was the surgery done well? Not necessarily. Although he did not know how to perform interventional surgery, he could not help but criticize him in his heart.
He was a little angry. Even his own chief had never talked to him so harshly. Who was this person? Why was he so annoying?
But even if he was annoying, he could not argue with someone in the operating room. Sun Zhenxing let out a long breath and tried his best to maintain his elegance.
In a few breaths, Sun Zhenxing calmed down.
He focused on the surgery and suddenly saw… that the embolic catheter was taking out a large section of the blood clot from the anterior tibial artery and pulling it out.
Was it past the knee?
The clot, which had been embolized for more than 48 hours… How did he get it out…