Chapter 228: Chapter 149: Debate Over the Surgical Plan—Who Will Lead the Operation?

Click~

The second emergency vehicle stopped and opened the door, and the emergency personnel jumped out, pulling out the stretcher.

“Multiple fractures, degloving injury to the foot, currently no abnormalities in internal organs.”

“Alright!”

Xiao Jing and all the doctors stepped forward, seeing the young boy on the stretcher in immense pain, his teeth clenched tightly, his entire body trembling lightly, already soaked in sweat.

As for the exposed left foot, from the ankle bone down to the heel, the entire skin, muscle, Achilles tendon, and nerve tissue were all torn.

Blood was staining the stretcher, but the ghastly white bones were still clearly visible.

Everyone frowned upon seeing this!

There was a large area of skin avulsion from the dorsal foot to the ankle joint, exposing the muscles and bone; this degloving injury is severe!

“Take him to the emergency room, start debridement and hemostasis, notify imaging to prepare CT, open the operating room, and the blood bank should prepare blood. Quick!”

Xiao Jing immediately instructed the nurse beside her.

“Come on! Transfer him! 1, 2, 3! Go, go, go!”

Swoosh~

Immediately after, the young boy was rapidly pushed into the emergency room.

“Mm~”

Xiao Jing frowned, having just touched the young boy’s calf, there was a muffled groan of pain.

She looked at the young boy, his lips were bitten to the point of bleeding, yet he didn’t cry out.

“I need to clean your wound now. If it hurts, just scream out, don’t hold back.”

Xiao Jing said to him.

But the young boy continued to bite his lips tight, shaking his head vigorously in silence, tears filling his eyes.

Xiao Jing, seeing this, no longer spoke. She injected tramadol for epidural anesthesia and started simple debridement with saline solution.

He was then carefully transferred to the CT room, gently placed onto the equipment for a full-body scan.

Quickly,

The images came out, and all the doctors in the emergency meeting room started the consultation.

Currently, no internal organ damage was found; the main issues were the fracture of the left thigh tibia, fracture of the lower leg tibia, and a severely injured foot.

In the CT images, the young boy’s left leg tibia was clearly broken and misaligned.

The lower leg had a slight fracture, there was a large wound on the foot, the fifth metatarsal bone was fractured, the left side calcaneofibular ligament was completely torn, and the joint was unstable.

“Dr. Sun, please share your thoughts.”

Xiao Jing looked at the male attending doctor from the orthopedic department.

This type of injury falls under orthopedics, so it’s critical to hear their opinion first.

“Alright, I’ll start discussing.”

Orthopedic Dr. Sun straightened up and said,

“The patient’s situation is now quite clear; with two-thirds of the skin from the foot’s middle distally and the sole completely degloved and torn, our department suggests that suturing can be attempted, and skin flaps are not necessary for now.

As for whether there will be necrosis later, it depends on the recovery situation. If necrosis occurs, I’m afraid amputation would be necessary.”

“I don’t think so.”

Just then, another doctor shook his head and sighed,

“With such an extent of degloving injury, the possibility of necrosis is very high, and with skin flaps, the sole won’t have the abrasion resistance; it will bring long-term pain to the patient, which I think is unnecessary.”

“So, you mean amputation?”

Xiao Jing frowned tightly upon hearing this and replied solemnly, seeing the other nod, she immediately disagreed,

“No, this child is only 7 years old. What should we do if we amputate now?”

“But once the sole necroses, the patient not only wasted a large amount of medical expenses but also endured the pain of a second surgery, who should bear this risk?”

…

For a while, there was a divergence of opinions on whether to amputate or attempt repair.

Indeed!

What they said was not wrong!

In this situation of the child’s degloving injury, choosing amputation is not unjustifiable.

But he is just too young!

The pain of amputation in the future life is long-lasting, and it can cause great trauma both physically and mentally.

And if we insist on preserving, according to orthopedic experience, attempting to repair such a large degloving injury and performing subsequent necrosis skin flap surgery are also excruciating for the patient.

Moreover, complete repair is already impossible.

The blood supply to the skin and the cutaneous nerves are severely damaged!

One must know the sole’s skin must be sensitive, in addition to general pain, warmth, and touch perception, it also needs a high degree of proprioception.

Furthermore, the subcutaneous tissue must be dense, to have abrasion resistance during weight-bearing, maintain stability in walking, and keep balance.

To prevent the formation of ulcers during plantar arch and friction!

Post-degloving skin debridement, in situ suture is difficult to survive, and while the survival rate of reimplanting stratified skin slices is high, it’s challenging to meet the sole’s special repair requirements.

In other words, the biggest difficulty in this surgery lies in suturing during surgery and survival post-surgery!

Each one is like a chasm!

And to succeed in both is akin to a death-defying attempt!

“What should we do?”

Xiao Jing was also anxious; the opinions on the surgery remained divided, unable to decide in the end.

Bang~

“Dr. Xiao, we’ve contacted the family.”

At this moment, the head nurse pushed the door open and said.

The family was found?

That’s great!

Xiao Jing’s eyes lit up with delight upon hearing the news. As long as the family comes, they can make a choice regarding the plan.

The voices of the crowd arguing also quieted down, understanding that the next step is for the family to make a decision.

“How is the child’s mother?”

Xiao Jing looked at the head nurse and asked.

“Compression fracture of the second and third lumbar vertebrae, comminuted fracture of the right arm, mild concussion, and no other problems detected so far.

The surgery will be scheduled soon, and she should wake up quickly.”

The head nurse explained the woman’s injuries, and Xiao Jing breathed a sigh of relief.

Fortunately, the injuries aren’t too severe~

If it were internal organs or brain injury, it would have been tragic.

“Alright, everyone, let’s finalize the two surgical plans, and once the family arrives, we’ll let them choose.”

Xiao Jing took a deep breath and looked at the attending doctors.

The group nodded and began preparing the two surgical plans.

But who should perform the primary suturing for the first plan?

After some debate, the orthopedic attending felt nervous.

To be honest, with such a degloving injury, he’s unsure about the survival rate if he were to suture it, but as a doctor, he wouldn’t want a young child to lose a foot if there’s even a sliver of hope.

So he still wants to give it a try!

“I’ll call the director to come and take a look,”

Xiao Jing said, standing up, and then went back to the office to call Zhou Xianren.

Zhou Xianren frowned as he saw the child’s injuries and fell into deep thought.

In this situation, considering it from a doctor’s perspective, the possibility of amputation is slightly higher.

But there’s still a chance for primary suturing, though it sets high demands for the lead surgeon and subsequent regeneration.

It even requires a bit of luck!

“Let’s try primary suturing first, and if necrosis does occur, we’ll consider a flap later.”

Zhou Xianren pondered for a moment before speaking, still ruling out immediate amputation,

“The child is too young. Regardless of the situation, we must consider it from a humane perspective. If there’s an opportunity, let’s try our best.”

“But who will be the lead surgeon?”

Xiao Jing nodded in agreement, but the most serious question arose.

Silence followed his words.

Indeed!

This is a major issue!

Both orthopedics directors are off duty tonight. Of the two attending orthopedic doctors on call, one is preparing for the child’s mother’s surgery, and the other is here.

Seeing everyone’s gaze fall on him, Dr. Sun shrank his neck in embarrassment.

He could handle this degloving injury, but…

The problem is still about the success rate!

“How about I call the director and ask?”

Dr. Sun from orthopedics looked at Zhou Xianren and said.

“It’s too late, it’s not appropriate.”

Zhou Xianren shook his head, refusing while his mind raced, and suddenly he stopped on someone’s figure, a gleam in his eyes,

“I know someone who might be able to lead.”

“Are you referring to Director Qin?”

Xiao Jing immediately responded.

“Yes, Qin Feng is still here, busy at the general clinic. He can take this surgery, perhaps with a better chance!”

Zhou Xianren nodded, a confident smile appearing on his face.

Qin Feng?

The others couldn’t help but feel a thrill at hearing this name!

Yes!

He is the top surgeon in the entire hospital!

Especially the orthopedic attending doctor, who excitedly stood up.

Director Qin, his suturing skills are outstanding!

If he really leads the surgery, he certainly would be more assured than myself… or perhaps even more assured than the two directors.

Great!

“I agree!”

Before others could speak, Dr. Sun voiced loudly.

Oh my God!

With Director Qin leading, wouldn’t I be the first assistant by necessity?

Watching Qin Feng’s entire degloving suture procedure live, this opportunity would surely make all the other doctors envious!

Fortunately, my senior went to perform the child’s mother’s surgery, or else that would have been a great loss!

If my senior found out he could join the surgery with Director Qin, he’d probably drop the forceps and rush over, swapping places on the spot.

Now it’s settled, no one can take this from me!

Hahaha~~~

Thinking of this, Dr. Sun couldn’t help but rub his hands with anticipation.

The other doctors quickly realized, looked at his excited expression, and couldn’t help but scowl.

Dammit!

He got it this time!

(╬▔︹▔)凸…

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