top student at medical school

Chapter 347 Immense Potential (First Update, Please Subscribe)
"Ziye, go out and discuss with the patient's parents, ask them if they agree to the option of secondary nerve suturing."

"My personal understanding is that suturing nerves and blood vessels simultaneously in one stage may actually lead to postoperative functional loss."

"Destructive nerve damage is not like the regular nerve rupture caused by a sharp object injury. Suture the tendons and blood vessels first, and ensure survival..."

"What do you think, Brother Wei?" Liu Huanglong did not flaunt the pride that belongs to a professor, but instead politely discussed the matter with Yuan Weihong.

Yuan Weihong pursed his lips and sniffed: "Professor Liu, currently, according to incomplete statistics, the survival rate of limbs damaged by atrocities is only 30% to 40%, and the rest all end up undergoing amputation."

Therefore, such statistical results are actually not statistically significant.

“Relatively simple catastrophic injuries should actually be classified as crush injuries. For simple catastrophic injuries, conservatively speaking, the chance of limb salvage is less than 10%.”

"For many prefecture-level city hospitals and top-tier hospitals, the preferred treatment for devastating injuries is primary amputation, reducing the number of surgeries and the financial burden on patients..."

"Prioritizing survival is indeed the first step forward. I've heard that some hand surgeons choose to perform secondary nerve suturing to further optimize procedures such as nerve transfer and nerve transplantation based on the functional impairment?"

Yuan Weihong is not completely ignorant about hand surgery, but when it comes to advanced treatments in various subspecialties, his knowledge is actually relatively limited.

This is similar to how programmers, each with their own strengths, can have different relative strengths and cannot be generalized.

“Then I’ll go out and talk to the patient’s family first. Before, I only discussed the two options with them: limb preservation and amputation.” Fang Ziye nodded, took a step back.

At first, Fang Ziye did not know that Professor Liu Huanglong would definitely be on the operating table. Of course, he could not give the patient's family too high expectations. If they had higher expectations than the final surgical result, Fang Ziye would have been in trouble.

Professor Liu Huanglong now has his own unique understanding, which is a knowledge gap that even top professors in trauma surgery lack. He has put forward suggestions, and Fang Ziye can only talk to the family again.

Informed consent is one of the most basic medical principles, and it must be done in non-emergency situations, no matter how impulsive you may be.

……

Fang Ziye took off his sterile surgical gown and mask. After leaving the operating room, he washed his hands at the sink, then twisted his neck and waist, heard a few cracking sounds, and felt his stiff joints ease slightly before walking out of the operating room.

After calling the girl's parents to the intraoperative consultation room via broadcast, Fang Ziye explained the situation suggested by Professor Liu Huanglong.

While the parents are away, besides worrying anxiously, they must be trying to find out about their daughter's chances of treatment through various networks, but what are the results they get?
Fang Ziye's words were undoubtedly a lifeline.

The girl's father had arrived, dressed smartly in a suit and shirt, though his hair was now a mess, his Adam's apple bobbing, and his mouth dry: "Dr. Fang, do you mean that for now, we can hope to preserve the shape of my daughter's foot, but whether its function can be restored can only be determined after the next surgery?"

“Yes!” Fang Ziye nodded.

"This option will require a second surgery, increasing the child's surgical burden, but it should offer a higher chance of recovery. Naturally, the financial burden will also increase accordingly..."

"After all, a second anesthesia is required..."

Fang Ziye's voice was interrupted by the man, who said decisively, "Dr. Fang, you don't need to deliberately bring up the economic issue. As long as it's not an astronomical figure, like hundreds of thousands or millions, we can afford it."

"In fact, under certain conditions, you can prioritize choosing better options, such as imported needles, threads, machinery, or materials."

"If you need to call in some specialists for consultation during the surgery, we are willing to cover the costs..."

The man, in the simplest tone and in the most "helpless" way at this moment, expressed his fatherly love.

Before the surgery, based on the girl's mother's account, it was clear that the girl's family was well-off.

She's a local from Seoul and can afford the cost of art students taking private lessons, so her family isn't poor.

Fang Ziye continued to explain: "The cost is definitely not as high as you said. Of course, everyone's situation is different. Perhaps tens of thousands of yuan is nothing to you, but in our hospital, including myself, we have encountered situations where we had to pool money from multiple sources or take out loans to pay tens of thousands of yuan."

"We doctors have an obligation to inform you that current treatment is not entirely a matter of finances, nor is it simply a matter of consulting specialists."

"In fact, your daughter's condition is considered a difficult-to-treat disease in the field of trauma surgery, both in China and worldwide..."

"Inviting experts to perform surgery requires a very mature surgical technique, and only when the experts are confident that they can handle the surgery can there be a chance to save the limb through remote technical assistance."

"So, hiring experts? It wouldn't be very helpful, no one would agree, and we can't find suitable candidates..."

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

Whether it's Jishuitan Hospital, or top-tier orthopedic hospitals like Shanghai Sixth People's Hospital or West China Hospital, no professor would be willing to come all the way from afar to perform an amputation under the guise of a "consultation" surgery, accept a high appearance fee, and then leave with the money.

If you don't have the skills, don't take on the job. If you can't handle a disease, your money won't help.

"Then let's follow Dr. Fang's choice for now. We'll do our best to help her get better, but if she can't, she's still our daughter no matter what." "We've done our best," the man replied.

Fang Ziye nodded.

The changes in surgical details during the operation did not actually alter the overall direction of the limb-sparing procedure. As for the specific surgical procedure and details...

For diseases like TM, there isn't even a standardized treatment plan, so where can you find a mature surgical procedure?

Can you tell me what the first generation of lithography machines was called?
Therefore, there was no need to change the surgical procedure, nor was it necessary to re-sign the consent form.

Fang Ziye rushed back again...

On his way back to the operating room, Fang Ziye slowed his pace slightly.

Based on what Professor Liu Huanglong told me today, Fang Ziye has gained a new understanding of the current surgical procedure framework, or rather, the progress of treatment for a certain disease.

The principles have long been written in textbooks, just like saving lives.

Save lives first, then treat illnesses.

Similarly, in the treatment of destructive injuries, the priority is to preserve the limb, then preserve function.

Before antibiotics were discovered and used, and before debridement and suturing techniques were fully developed, all injuries to the limbs were treated with amputation to save lives.

Before vascular surgery was fully developed and before the surgical techniques for removing arterial thrombi were developed, arterial thrombosis in the lower limbs always resulted in amputation to save lives.

Before limb replantation surgery was fully developed, the treatment of amputated limbs was simply to suture the stump to save the patient's life.

Before tumor resection surgery, also known as lesion debridement and resection, was fully developed, orthopedic tumor patients often had to undergo amputation to save their lives.

In the beginning, there was no corresponding mature surgical procedure to treat each new disease in medicine. At that time, the treatment relied on the most basic skills, with the goal of saving lives.

Therefore, in the face of new diseases, everyone is equal. Everyone relies not on highly sophisticated and intricate surgical procedures, but on the most basic surgical skills to cope with them.

Then, step by step, specialized surgical procedures corresponding to new diseases were developed, and mature surgical techniques were created.

Of course, there is also inequality when it comes to new diseases.

Professors generally have better basic skills, at least core basic skills, than ordinary doctors. Therefore, they are more adept at handling new diseases and have more room for error.

Based on this, Fang Ziye looked at the two level 5 skills on his panel and felt relatively relieved.

Debridement level 5, suturing level 5.

These are the two most basic surgical procedures, and their potential is enormous when faced with unknown diseases.

Once a treatment plan for such a disease can be successfully developed, the benefits to both patients and developers will be enormous.

Naturally, if procedures such as vascular suturing and nerve suturing are specialized operations in hand surgery, and the proficiency level of these specialized operations, which are currently mature and applied in hand surgery, can reach level 5, then there will definitely be a better solution for handling injuries and a more composed approach.

But there's nothing I can do; my knowledge is limited.

However, even though he had limited resources and couldn't reach level 5, Fang Ziye still chose to increase his skill points in operations such as nerve suturing to level 4.

Although Professor Liu Huanglong took over the nerve suturing, Fang Ziye might still have the opportunity to perform it. If Professor Liu Huanglong thinks highly of his basic suturing skills and lets him participate in the suturing of one or two nerves, wouldn't that be even more knowledge?

In addition, Fang Ziye has a huge foundation!

Manual reduction technique, level 5.

This level of proficiency is beyond the reach of many trauma surgery professors. Therefore, when I return this time, after suturing the blood vessels and prioritizing blood flow to the limb stump, the potential I can unleash when dealing with the fracture residue is also limitless.

Professor Duan Hong recently sent a case of devastating injury to Zhongnan Hospital, which was actually because he was impressed by the level of his manual reduction technique; he didn't send another case later, probably because the patient with the devastating injury did not recover well.

The limbs survived, but not well. Like Huang Kai from Enshi, he is currently in a state of hemiplegia. The limbs survived, but they are just decorations.

This time, Fang Ziye can collaborate with Professor Liu Huanglong, who specializes in treating neurological diseases in hand surgery. Perhaps, this collaboration will unleash unimaginable potential and staying power.

(End of this chapter)