"Ziye, you go out and discuss with the patient's parents and ask them if they agree with the option of second-stage suturing the nerve."

"My personal understanding is that the simultaneous suturing of nerves and blood vessels in the first stage will lead to the loss of function after surgery."

"A broken nerve is no more regular fracture than a sharp injury. Suture the tendons and blood vessels first to ensure that you are alive first......"

"What do you think, Viagra?" Liu Huanglong did not show off the pride of the professor, but politely discussed with Yuan Weihong.

Yuan Weihong pursed his lips and sniffed at the same time: "Professor Liu, at present, the damage to the limb, according to incomplete statistics, the chance of survival is only 30 to 40 percent, and the rest are all turned to amputation." ”

"Therefore, such statistical results are not actually statistically significant."

"Relatively simple damage injuries should actually be classified into the category of crushing injuries, simple damage injuries, conservatively estimated, less than 10% chance of limb salvage."

"In more prefecture-level city hospitals and tertiary hospitals, the treatment of damage is the first amputation, which reduces the number of surgeries and the economic burden of patients......

"Thinking about being alive first is indeed the first step forward, and I heard that some patients in the Department of Hand Surgery will choose to suture the nerve in the second stage and further optimize the nerve transposition and nerve grafting according to the failure of the function."

Yuan Weihong is not completely ignorant of hand surgery, but if he wants to play with high-end treatment in various subspecialty fields, his understanding is actually relatively blank.

It's like being a programmer, but in fact, each programmer's relative expertise is different, and it must not be generalized.

"Then I'll go out and talk to the patient's family first, and I only discussed with them two options: limb salvage and amputation." Fang Ziye nodded, stepped back and stepped back.

At the beginning, Fang Ziye did not know that Professor Liu Huanglong was 100% on stage, of course, it was impossible to give the patient's family too high expectations, and when the time came, Fang Ziye would inevitably be in trouble if he expected higher than the final surgical result.

Now Professor Liu Huanglong has his own unique understanding, which is a gap in the knowledge that top professors of trauma surgery are vacant, and put forward a suggestion, Fang Ziye can only talk to his family again.

Informed consent, one of the most basic medical principles, no matter how hot the brain is, must be fulfilled in the case of non-emergency avoidance.

……

Fang Ziye took off the sterile surgical gown, took off the sterile mask, washed his hands by the sink after going out, then twisted his neck and waist, heard a few clicks, and felt that the stiff joints were slightly relieved before walking outside the operating room.

After the girl's parents were summoned to the intraoperative interview room via radio, Fang Ziye explained the situation suggested by Professor Liu Huanglong.

Parents are outside, in addition to being anxious, they must still be inquiring about their daughter's treatment hopes and possibilities through various networks, but the result is just the result?

Fang Ziye's words are undoubtedly a lifesaver.

The girl's father had already arrived, dressed decently and generously, in a suit and leather shirt, but his hairstyle at the moment had been rubbed extremely messy by him, his Adam's apple was stirring, and his mouth was dry: "Doctor Fang, do you mean that my daughter's current injury can be expected to preserve the shape of her feet at present, but whether the function can be restored can only be said in the next operation?" ”

"That's right! ~" Fang Ziye nodded.

"With this option, the second-stage surgery will be performed, which will increase the burden of surgery on the child, but there should be more chances of recovery. Naturally, the financial burden will also increase relatively ...

"After all, you need a second anesthesia..."

Fang Ziye's voice was interrupted by the man, very decisively: "Doctor Fang, you don't have to deliberately remind the economic problem, as long as it is not astronomical, hundreds of thousands of millions, we can afford it." ”

"Even, under certain conditions, you can give preference to better ones, such as imported needles and threads, machinery or materials, which are all possible."

"If you can temporarily invite some experts to consult with some experts during the operation, we are willing to bear the cost......

Men, in the most simple tone, in the most "incompetent" form at the moment, embody their father's love.

Before the operation, according to the words of the girl's mother, it was possible to imagine that the girl's family was well-off.

Native of Han City, and can afford the cost of art students, go to private lessons, and the family will not be very poor.

Fang Ziye continued to explain: "The cost is definitely not as high as you said, naturally, everyone's situation is different, maybe tens of thousands of yuan is not worth mentioning to you, but our hospital, including myself, has encountered tens of thousands of yuan that need to be pieced together, borrowed, etc." ”

"We doctors have an obligation to inform, but in fact, the current treatment is not entirely a matter of economy. It's also not a matter of consulting a specialist. ”

"In fact, your daughter's situation is a refractory disease in the field of trauma surgery in China and even around the world......

"Inviting experts to come over for surgery, if it is a very mature operation, and the experts have a certain degree of confidence that they can handle the operation, they will have the opportunity to complete the rescue of the limb through remote technical assistance."

"So, experts please? It won't make a lot of sense, no one will say yes, and we won't find the right person......"

This has to be explained clearly, it's not that Zhongnan Hospital is arrogant, but that you can't find the right person.

Whether it is a top orthopedic hospital such as Jishuitan, the Sixth Hospital of Modu, or West China, there will be no professor who is willing to take a high appearance fee in the name of 'consultation' surgery, and finally come thousands of miles to have an amputation and take the money and leave.

There is no diamond, no porcelain work, and diseases that cannot be handled, and it is useless for you to pay for them.

"Then, let's follow your choice first, Doctor Fang, if you can do it as well, if you really can't do it, no matter what, this is also our daughter."

"I did my best." The man responded.

Fang Ziye nodded.

The details of the operation during the operation have changed, but in fact, the direction of the major operation of 'limb salvage' has not been changed, as for the specific surgical method, the details of the operation.

For such a disease as TM, there is no standardized treatment plan, where is there a mature operation?

Can you tell me what the name of the first generation lithography machine was?

Therefore, there is no modification of the surgical method and there is no need to re-sign.

Fang Ziye rushed back again......

It's just that on the way back to the operating room, Fang Ziye slowed down his pace slightly.

According to some of the things that Professor Liu Huanglong told today, Fang Ziye re-understood the current surgical structure, or in other words, the treatment process of a disease.

Principles have long been written down in textbooks, as are saving lives.

Save first, then heal.

Similarly, the treatment of damage is to preserve the limb first, and then to preserve the function.

Before antibiotics are found, before debridement and suturing are fully developed, all injuries to the limbs are amputated to save lives.

Before the development of vascular surgery and the development of arterial thrombosis, the arterial thrombosis of the lower limbs was amputated to save life.

Before amputated limb replantation is matured, the treatment of amputated limb is to suture the stump to save life.

Before tumor resection, also known as lesion debridement and resection, has not developed and matured, patients with orthopedic tumors are also amputated to save their lives.

For every new disease in medicine, there was no corresponding mature surgery to deal with them at the beginning, and at that time, they all relied on the most simple basic skills to deal with them, based on life-saving.

Therefore, in fact, in the face of new diseases, everyone is equal, and everyone relies not on high-precision and cutting-edge mysterious surgical operations, or the most basic basic skills of surgery to correspond.

Then, step by step, a specialized surgical method corresponding to the new disease, mature surgery, is developed.

Of course, in the face of new diseases, there is also inequality.

Professors' basic skills, at least the core basic skills, are generally better than those of ordinary doctors, so they will be more handy in dealing with new diseases and have more room for error.

Based on this, Fang Ziye looked at the two level 5 skills on his panel again, and his mood was relatively comfortable.

Debridement grade 5, suture grade 5.

These are the two most basic operations of surgery, and the potential it can unleash is huge when faced with unknown diseases.

And once such a disease can be maturely promoted to the treatment plan, the benefits to patients and developers themselves are also huge.

Naturally, if you are a specialist in hand surgery, such as vascular suture and nerve suture, and you are now proficient in hand surgery, you will definitely be able to deal with damage more calmly if you have reached level 5.

But there is no way, the knowledge is limited.

However, even if it was limited and he couldn't rush to level 5, Fang Ziye still chose to add operations such as nerve suturing to level 4 proficiency.

Although the nerve suture was taken over by Professor Liu Huanglong, it may not be that Fang Ziye will not have the opportunity to operate, in case Professor Liu Huanglong can afford his basic skills in suturing and let himself participate in the suturing of one or two nerves, wouldn't it be more knowledgeable?

In addition, Fang Ziye also has a huge heritage!

Manual reduction grade 5.

This is a level of proficiency that many professors of trauma surgery cannot reach, so the potential for the explosion of the fracture when I go back this time, after suturing the blood vessels and giving priority to the blood flow of the limb stump, when I take care of the fracture residue by myself, is also endless.

Professor Duan Hong would put a case of destruction in Zhongnan Hospital some time ago, but in fact, he took a fancy to his own level of manual reduction; Later, I didn't put it again, and it is estimated that it was the patient who was damaged, and the recovery was not good.

The limbs survived, but they didn't live well enough, like Huang Kai in Enshi, they are currently in a hemiplegic state, and the limbs survived, just an ornament.

And this time, Fang Ziye can cooperate with Professor Liu Huanglong, who is good at the treatment of neurological diseases in hand surgery, and maybe he can burst out with unimaginable potential and stamina.

(End of chapter)