Path of Medicine With a System
chapter-293-30041322

Chapter 293: Black thread bracelet

The first successful hand reattachment surgery in China had been accomplished back when China’s medical conditions and environment were still really poor. That was something amazing. One of the primary surgeons for that surgery was connected to Qiu Fazu, the father of modern Chinese surgery.

Back then, China had yet to import even one slightly advanced medical microscope. Despite this, the medical geniuses of that generation had managed to succeed at hand reattachment surgery. But after that, after a certain period of time, Chinese society became such that money was considered more important than anything. Limb replantation surgery swiftly went down a downhill slope in Chinese medical development, despite other Chinese medical fields rapidly advancing to catch up with the rest of the world. All of this was due to the lack of benefits associated with limb replantation surgery for Chinese public hospitals.

Wang Congcong was pushed into the operating room on his gurney. The doctors were all tense as they finished the pre-surgery preparations to correct his shock. Little Wang Congcong seemed to be really weak and withered.

He no longer even had the energy to cry. His small face was incredibly pale. The strangers around him were all wearing green surgical attires, blue surgical caps, and blue face masks, which made them seem like monsters to him. The frightened young boy curled up into a ball as much as possible as if that would give him some slight sense of safety after being separated from his mother.

Wang Congcong received fluid infusion to correct his shock. He was then given a sedative which knocked him unconscious. Meanwhile, Zhang Fan and Li Liang prepared the cut off hand for reattachment while the anesthesia for the boy was being prepared.

“Prepare Kirschner wires and bone nails. Metal plates can’t be used for this surgery!” Zhang Fan told the medical equipment nurse as he disinfected the cut off tiny hand.

“Director Zhang, why aren’t we using metal plates?” Li Liang didn’t understand. He had stopped referring to Zhang Fan as “Brother Zhang” ever since Chen Qifa had told him not to do it anymore.

“Metal plate affixation is too damaging to the periosteum, especially in young children. It’s best to avoid damaging the periosteum if at all possible,” Zhang Fan explained. There were many advantages to using metal plates in bone affixation. However, the greatest disadvantage to metal plates was the damage to the periosteum.

The periosteum was a dense layer of vascular connective tissue enveloping the bones. It contained a large number of blood vessels and nerves. Damage to the periosteum would be permanent. It was far too difficult to repair any damaged nerves in the periosteum.

Metal plates were all mass-produced. When using them, it would be absolutely necessary to ensure that the metal plate and the bone were as close to each other as possible. If the two weren’t close enough to each other, either the metal plate would snap, or the bone fracture wouldn’t be affixed securely enough.

In order to ensure that the metal plate and the bone were as close to each other as possible, the surgeon would have to use a bone scalpel to destroy the periosteum at that location. Meanwhile, Kirschner wires were far simpler. It would act in a way similar to knitting, where two intersecting straight lines would support and affix something. However, why were Kirschner wires used much less compared to metal plates in Chinese surgeries now? The reason was quite simple. It was because Kirschner wires were much cheaper, which provided less benefits through kickbacks to the doctors!

Zhang Fan finished cleaning and disinfecting the tiny cut off hand. He then told Li Liang, “Flush this with heparin saline.” Zhang Fan held on to the tiny hand so that the broken portion was facing Li Liang. This tiny hand seemed almost just like a tiny pig foot, especially with the skin color being identical.

Washing the broken portion with heparin saline was to help the remaining blood inside the hand to prevent intravascular coagulation. One of the key elements in whether a limb replantation surgery would be successful or not was how high in quality the blood vessel reattachment was in ensuring that blood could smoothly flow again. The first step to ensuring all this was to rinse and preserve the remaining blood inside the limb.

As Li Liang rinsed, Zhang Fan used black threads to tie the blood vessels and nerves. He was marking them. For this type of surgery, not even one moment of time could be wasted.

The anesthesia had been prepared by the time that Zhang Fan and Li Liang finished preparing the cut off hand. Zhang Fan and Li Liang then began the surgery.

The medical equipment required for hand and foot surgery was quite similar to medical equipment for vascular surgery or ophthalmology rather than orthopedic surgery. The medical equipment was mostly tiny and exquisite, unlike in orthopedic surgery, which mostly used medical equipment similar to what a carpenter would use. Orthopedic surgery medical equipment would be hammers, saws, bone files, bone scalpels, and electrotomes! Carpenters would definitely be familiar with similar versions that weren’t specialized for bones!

Wang Congcong’s father’s older brother’s family also worked at the Rural Electricity Bureau. Wang Congcong’s uncle was a low-ranking manager, while Wang Congcong’s parents were both ordinary employees. Wang Congcong’s uncle was a nice person, but his wife was the type who often stirred up trouble.

“Sheesh! Just how were you watching the little boy? He’s young and doesn’t understand anything, but does that also mean that you don’t understand anything? All of you in the family add up to about 200 collective years of experience, but you still couldn’t even watch over a four-year-old boy properly!” Wang Congcong’s aunt-in-law spoke in a really sharp and accusatory tone. Her words were truly heart-piercing!

Wang Congcong’s grandparents were both feeling really guilty already. Their hearts just about shattered when they heard this. They really felt pained regarding their grandson. They felt so much regret, but what could they even say? The grandparents didn’t even have the right to cry. They were being viewed as villains! They felt so bad!

Wang Congcong’s uncle was also feeling really bad about the situation. He roared in a low voice at his wife. “Shut up! If you’re going to keep talking like this, just go home!”

Wang Congcong’s uncle then turned to his younger brother, and whispered, “Do you have enough money with you? I brought my bank card. You absolutely must tell the doctors to use the best medicine and medical equipment. There’s not enough time now, but you should have given the doctors some red packets before the surgery started. This is such a major incident, sigh! Who’s the person in charge of this hospital? I’ll go set things up with them.”

Wang Congcong’s uncle was interrupted when Chen Qifa arrived with the prepared surgery agreement form. “Please come with me to the office and sign this paperwork.”

Wang Congcong’s father supported his wife as they trudged over to the office. Wang Congcong’s uncle followed them as well. Wang Congcong’s aunt-in-law also immediately came with them because she didn’t want her husband to give his family any money!

Wang Congcong’s grandparents were just like mannequins now. They had blank expressions as they looked at the “Surgery in progress” green light on the operating room door.

“Here, and here. This is the difficulty level of the surgery and the dangers involved, along with potential side effects after the surgery. Please sign here!” Chen Qifa informed them about the surgery, and pointed at the place for the family members to sign.

Wang Congcong’s parents were basically just like lambs who would easily be taken advantage of. They wouldn’t dare to resist or object to whatever price or demands the doctors named! They were afraid that their actions might affect the doctors in any way.

“Please remember to pay the necessary medical fee,” Chen Qifa told them.

“Director, about how much money will it be?” Wang Congcong’s uncle asked. Wang Congcong’s parents were already like zombies who would do anything that they were told to do. Their ability to think had already shut down completely.

“Approximately 20,000 yuan!”

“Alright, I’ll go pay the medical fee right now.” Wang Congcong’s uncle then went to go pay the medical fee. However, his wife started panicking and pulled on the back of his shirt, refusing to let go.

Without saying anything, Wang Congcong’s uncle pushed aside his wife’s hand, and then went to go pay the medical fee. His wife felt like knives were stabbing into her heart from this. They were just an ordinary family. 20,000 yuan would be no small number for an ordinary family!

Now, Wang Congcong’s aunt-in-law was just like a third zombie as she and Wang Congcong’s parents woodenly walked out of the office.

Suddenly, the aunt-in-law seemed like she came alive again with the desire to spew more insults. “Just look at you, not only are you incapable of taking care of your son, what trashy hospital have you found here? Why didn’t you go to a public hospital!?”

Wang Congcong’s parents still remained like zombies! They didn’t respond at all, just as if they were deaf!

However, Chen Qifa heard her words. “Hey! Ma’am, that’s not something you should say. Trashy hospital? Go find out information for yourself. In all of Chasu City, if our hospital says that a limb replantation surgery is impossible, then no other hospital in the city will possibly take the patient! We’re this at limb replantation surgery in Chasu City!” Chen Qifa flashed a big thumbs up! He was really proud!

Of course he would be proud. Previously, he had been a minor doctor at Kuake City Hospital who didn’t even have a medical license. Now, he was the surgical director at Zhang Fan’s hospital, which exceeded even Chasu City Hospital in skill level at limb replantation surgery. Chen Qifa had plenty to be proud of!

Meanwhile in the operating room, Zhang Fan and Li Liang were swiftly and tensely proceeding with the surgery. “When performing surgery on young children, it’s critically important to consider the child’s future development. The epiphyseal plate is especially important. Don’t touch it if at all possible,” Zhang Fan lectured Li Liang as they worked on the surgery.

Doctor Song Bing acted as an operating room nurse. Li Liang and Song Bing would always work as Zhang Fan’s surgical assistant or nurse whenever he was performing surgery. Both of them would never let go of any opportunity to watch and learn from Zhang Fan!

Cleaning the injury was the first step in performing surgery on any traumatic injury. This step was highly important. Excellent cleaning would be the strongest foundation for any limb replantation.

The muscles would become dull to stimulation around three to four hours after losing blood supply. Luckily, Wang Congcong had been brought over as soon as possible, so his condition was still alright.

Limb replantation was about preserving a complete physical body as well as maintaining the reattached part’s function.

In order to preserve the complete physical body, the prerequisite would be proper bone affixation and blood vessel repair. The blood vessels absolutely needed to be sewn together very skillfully.

As for preserving the body part’s function, that would be about repairing the nervous system. To explain simply, the farther away a body part was from the heart, the greater the chances of successful limb replantation. This was because the blood vessels and nerves would become smaller farther away from the heart. Basically, the larger the blood vessels and nerves, the harder they would be to repair, and the harder it would be to restore functionality!

Zhang Fan swiftly used heparin saline to rinse the blood vessels. Li Liang’s current skill level as a surgical assistant was just barely passable enough to work as fast as Zhang Fan. Li Liang had worked hard at improving his own skills not to slow Zhang Fan down.

Zhang Fan finished cleaning the injury and began to affix the bone fracture. The young boy’s bone was pure white and as narrow as a chopstick.

“Sigh! Such a young child had to suffer so much,” Li Liang commented. He had already worked on countless limb replantation surgeries already, but even he couldn’t help but feel pity for the young boy in this condition.

A Kirschner wire was attached to the electrotome for the bone affixation process. Zhang Fan connected the ulna and radius and used a 30-degree angle as he gently pierced through the bone with the electrotome which spun at a high speed. These types of clean breaks were the easiest to affix.

Zhang Fan then affixed the bone with intersecting Kirshner wires. His affixation was extremely exquisite. He didn’t hesitate one bit. He didn’t even have to slow down to ascertain anything. That was how well practiced and precise he was in his movements.

Li Liang was unable to see this, as he was standing at the surgical assistant’s position. However, Song Bing was able to see everything quite clearly as he was standing at the operating room nurse’s position. He kept shouting in his mind, ‘Wow! Wow! Wow! So that’s how it’s done! Oh! Why did he do it like this!?’ Song Bing felt a constant mix of excitement and confusion. He was going to study all night again after finishing his work on this surgery!

Zhang Fan finished affixing the bone fracture and muscle tendons. Next was the blood vessels. This part would require a microscope. The success or failure of the surgery would depend on this critical part of the surgery. However, this surgery wasn’t difficult at all for Zhang Fan.

Zhang Fan’s movements were rather robotic. He had practiced countless times before in his System, giving his muscles perfect muscle memory which was completely standardized in every movement on how to balance gentleness and swiftness.

Zhang Fan finished sewing up the nerves and then the skin. “Okay!” he gently announced after finishing the surgery. Once he said this, it was as if the operating room had just unthawed from a deep freeze. Everyone came alive again.

“Director Zhang, are you tired? I’ll feed you some glucose!” Song Bing acted sycophantically to Zhang Fan.

“I’m fine. You guys need to remember that you still can’t relax at all yet. You absolutely must observe the reattached hand to see if there’s any change in the skin or temperature.”

“Alright,” Li Liang and Song Bing replied and nodded simultaneously.

Zhang Fan had successfully reattached Wang Congcong’s hand. However, there was an obvious difference in colors between the hand and the arm.

The previously cut off hand had really pale skin. It seemed just like an artificial hand. However, this skin was now changing color again at a visible rate due to receiving blood flow once again. Proper skin color was being gradually restored.

Around 15 seconds later, as if it was magic, the hand’s skin color completely returned to normal. The only visible difference was that there was a black thread all around the severed location, just as if the young boy was wearing a black silken bracelet which had been sewn into his wrist! The black thread really did look quite nice and cute. At the very least, this black thread looked far more pleasant than a bleeding stump which revealed white bone!

“For postoperative care, make sure to pay constant attention, especially within the first 24 hours after the surgery. You absolutely can’t let down your guard,” Zhang Fan told the other two doctors.

“Okay,” Li Liang and Song Bing replied and nodded simultaneously.

The surgery was now finished! Wang Congcong’s hand had been successfully saved. The surgery had taken a bit more than three hours.