"Okay, take out your Kirschner needles and take a look." Ling Ran checked the Kirschner needles in Huang Maoshi's box, nodded, and asked, "Free?"

"Yes. We have quotas for manufacturer promotion..." Huang Maoshi quickly introduced the situation.

Ling Ran selected the commonly used type, then nodded to Nurse Liu and said, "Please ask someone to clean and disinfect it. It will be ready later."

"Okay." Nurse Liu waved her hand familiarly and left with Master Huang Mao.

The medical staff in the hospital have long been familiar with the presence of medical representatives, including in the operating room, where medical representatives come and go.

Especially for consumables that are used in small amounts, medical representatives often just call the hospital or doctor and have them delivered.

In hospitals below the local tertiary level, medical representatives carrying suitcases are like mobile consumables warehouses. The hospital cannot build its own consumables warehouse, or the consumables warehouse is too small, so it uses this method to supplement. Usually the head office

Notify the medical representative in a day or two, and the medical representative will deliver the consumables the next day, and then the nurses will clean them and send them to the operating table.

However, for things like Kirschner wires, which cost only 100 yuan for a cheap one and 800 yuan for an expensive one, they usually can only be stored in the hospital consumables warehouse.

The medical representative was too lazy to send it.

Of course, just like laying down the towel, there are always exceptions.

The medical representatives were now trying their best to get close to Ling Ran, not to mention bringing Kirschner needles to the operating room, even bringing a needle. They could only get close to Ling Ran and show their face. Huang Maosheng was happy with it.

At about the same time, the patient was also wheeled in.

Su Jiafu first stood up to do various examinations, and then received anesthesia.

Lu Wenbin, Yu Yuan and others hurriedly started laying out towels.

Ling Ran leaned over to examine and assess the patient's wound condition.

It is inherently difficult to suture four severed fingers, and the broken finger was injured by a firecracker. Among the hand injuries, it is also a clear and complex injury, so it is very difficult to suture.

The most difficult part is that the young patient's fingers have skin defects and arterial defects.

Ling Ran was observing and thinking, and then took out the X-ray film he had just taken and read it.

After looking at it for a while, Ling Ran shook his head and said, "Call Director Wang Haiyang. You can't do this finger well because the blood vessels are too thin. Well... the index finger may have to be given up."

The index finger is the name for the index finger in medicine. It is also the most seriously injured part of this bombardment. Not only the bones were shattered, but the skin and tendons in the middle were also heavily fragmented and burned. During the careful debridement, the index finger might even be damaged.

To peel off.

Lu Wenbin and Ma Yanlin looked disappointed. They had been with Ling Ran for the longest time and had done the most replantation of severed fingers. If two surgeries were performed at the same time today, they would have the opportunity to be the chief surgeons.

However, the blood vessels in fingers are inherently thin, let alone the blood vessels of children, and the gunshot wounds are so complex that neither Lu Wenbin nor Ma Yanlin are confident that they can do it.

"Call all the interns here too." Ling Ran warned again, and then went back to watching the movie.

A huge difference between the chief surgeon and the assistant is that the chief surgeon determines the direction of the surgery.

For a successful operation, the surgeon must be familiar with it and plan every step well before starting the operation. For those with higher skills, he must also consider how to deal with unexpected situations.

Of course, the more you have done the same surgery, the more you have considered the same thing, and the more experience you have in dealing with unexpected situations, you can omit many preoperative steps. However, watching the images is indispensable after all.

"Didn't you take an MRI?" Ling Ran asked with his back on the operating table.

Yu Yuan said: "The MRI machine is being cleaned..."

When MA breaks out, all departments are not immune.

Ling Ran said helplessly: "Okay, the X-ray can basically be seen clearly. How long does it take for Director Wang Haiyang to arrive?"

"three minutes."

"Then wait a minute, have the signatures been signed?"

"Double signatures. The child's parents are divorced and the mother is currently not in Yunhua City. His father and aunt signed it." Yu Yuan explained a few sentences carefully.

Ling Ran nodded in "grace" and continued to look at the patient's wounds and think.

Lu Wenbin opened the towel and looked at the patient's face before saying, "This naughty kid is only eight or nine years old."

"It's not unreasonable for seven or eight years old to be disgusted by dogs." Zuo Cidian said: "When we were in the town health center, in various emergency departments, the naughty children at this age were the most amazing. I have seen them eating dirt.

Some people have diarrhea, and I’ve even seen people taste their own feces..."

"Why do you want to eat shit?" Yu Yuan couldn't believe it.

"What does the naughty kid say? He said that his family keeps calling him "stinky dog ​​shit, stinky dog ​​shit, stinky dog ​​shit", and he just wants to taste if dog shit really smells?"

Everyone in the room was attracted.

Yu Yuan laughed so hard that she couldn't breathe: "Of course it stinks, you can even smell it. The smell comes from the sense of smell, not the sense of taste."

"How do children understand these things? Don't tell me, what you smell with your nose is always different. Tasting it proves it more directly, right? It's just like durian." Zuo Cidian suddenly felt a touch of nostalgia in his heart. He felt disgusted and even disgusted.

Yu hated the town health clinic, but after all, his youth was left there.

Lu Wenbin asked strangely: "Even if you eat dog poop, you won't have to go to the hospital, right? Does the health center care about this?"

"Oh, that naughty kid was bitten by a dog when he was trying to hot dog poop." Zuo Cidian gave a reasonable answer.

Yu Yuan asked doubtfully: "Is it because his family said you should eat shit while it's hot?"

Zuo Cidian was stunned for a moment and said: "Probably, the naughty kid has already eaten shit, who cares why he wants to eat hot dog shit."

laugh.

The airtight door opened and Director Wang Haiyang rushed over.

"Everyone is here." Wang Haiyang tied his hands with a smile and asked the nurse to help put on the surgical clothes.

"The 8-year-old child was injured by firecrackers and lost four fingers..." Zuo Cidian stepped forward quickly and began to introduce the situation.

Wang Haiyang and Ling Ran did something similar, they also watched the movie before looking at their hands.

"This indication is useless." Wang Haiyang's judgment was similar to Ling Ran's, and much more decisive than Ling Ran's.

The naughty child's homemade cannon was so powerful that it almost exploded in his hand. Therefore, the damage to the bones, tendons and blood vessels was very serious, and the injury to the index finger, which bore the brunt, was even more serious.

Ling Ran nodded and said: "You can try replantation, but it will be more difficult to achieve excellent standards."

If it doesn't meet the excellent standards, it's just a look.

Of course, it would be nice to be able to show off.

At the very least, you won't be stared at by strangers.

Wang Haiyang looked at it carefully for a while and said: "Ling Ran, this injury is enough to meet the standards of ectopic foster care. Do you want to give the index finger to foster care?"

His suggestion instantly attracted Ling Ran.

For the finger, ectopic foster care means that it is first transplanted to other parts of the body, and then transplanted back to the hand after the wound on the finger itself has healed.

If one transplant becomes two transplants, the final effect will definitely not be as good as one.

However, for fingers that do not have sufficient conditions for first-stage replantation, it is always good to have the opportunity for second-stage replantation.

Ling Ran thought quickly for a few seconds and said, "I don't know how."

"Hey, don't you know how?" Wang Haiyang suddenly became interested. Looking at Ling Ran, he almost shouted "Let me teach", "Let me teach".

Ling Ran nodded: "I have never learned about ectopic foster care."

His perfect replantation of severed fingers is limited to finger joints. Heterotopic fostering can be regarded as another specialized skill. Not only fingers can be ectopic fostered, but also arms, calves, ears, noses, etc. can be ectopic.

Foster care.

"Ordinary orthopedic or hand surgery doctors don't learn ectopic foster care. It's impossible for today's private hospitals to engage in this project." Director Wang Haiyang laughed twice and added: "But I can,

Why don't you just transplant the index finger ectopically today, and I'll give you on-site instruction, and in a few weeks, we'll do the second-stage replantation."

Wang Haiyang was extremely happy to be able to teach Ling Ran.

This is why the hand surgery department of Yun Medical Hospital is an elite department. In other hospitals, ectopic foster care can be used as promotional materials for 10 years.

At Yunyi Medical Center, ectopic placement of a finger can only be considered a preliminary stage, and ectopic placement of an arm is done several times a year.

Being able to learn new things gave Ling Ran a little bit of excitement.

He looked at the little patient's index finger again and said: "Then inform the patient's family and ask them if they are happy with it. We will replant the other three fingers first. Doctor Zuo, go and ask."

"Okay." Zuo Cidian agreed immediately, took off his surgical clothes and left.

"We can give them some fee reductions. For 30% to 40%, go to your Director Huo and he will definitely approve it. Ling Ran will give you Director Huo a call." Wang Haiyang stopped Zuo Cidian, talked, and then said: "

The medical expenses of ectopic fostering are much more expensive than replantation, and the care during the finger fostering period is also troublesome. But you should explain clearly to them that based on the current condition of the child's index finger, you should not use ectopic fostering. My suggestion is

If the limb is amputated, the possibility of forced replantation is very high. In addition, ectopic foster care can also preserve the appearance better."

Zuo Cidian wrote it down, and his steps when he went out were not so quick.

Such a conversation is quite difficult.
Chapter completed!