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"Ling Ran, continue with the ring finger on the left hand . " It was impossible for Wang Haiyang to not utilize Ling Ran and have other people finish the tasks at hand .
Finger replantation surgeries were one of the operation types that required the surgeon to fight for every second .
Today's operation was the same .
In order for a five-year-old patient to have eight functional fingers, the surgeon had to complete the stitching process as soon as possible for her .
Being precise and fast was the main requirement for a replanted finger's postoperative recovery . Blood supply was vital . It was of utmost importance that they recovered the finger's blood supply as quickly as they could .
No one knew how long it would take before a severed finger suffered too much blood loss and went through necrosis . Perhaps it would be twenty hours, eight hours, or perhaps even twelve hours . The longest-surviving severed finger lacking blood was fifty-six hours, and it was successfully replanted by Wuxi People's Hospital . However, no one would be willing to take the initiative to challenge that record .
Different people had different situations, but one thing was certain: if you restored the blood supply of the severed finger as soon as possible, it would recover better, and its functionality would be stronger as well .
Group 1, Group 2, and Group 3 were only halfway through with replanting the severed fingers . Everyone had yet to complete the most important anastomosis . There was also the similarly complex nerve anastomosis waiting for them . . .
With their current speed, they would not be able to finish within one and a half hours .
Under such circumstances, forget about asking Ling Ran to give up his space . There was also no reason for other doctors to take over for him . Ling Ran operated the fastest, plus he was also young and energetic . Allowing him continue was be the best choice .
Regardless of speed or quality, the replacement doctors could not match the chief physicians and associate chief physicians . With that being the case, there was no hope for them to replace Ling Ran .
Wang Haiyang did not even have to weigh the pros and cons . He made his decision in an instant .
He needed to be responsible for the entire operation . He could not be responsible for the dignity of another doctor . To put it in a less flattering manner, surgeons who could not perform a surgery well did not have any sort of dignity to speak of .
This was especially so in provincial tertiary grade A hospitals like Yun Hua Hospital . Most of the surgeons walked down the path of skills . Those who did not have good skills would be looked down upon by the others . That was politically correct, there was no doubt about it .
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Wang Haiyang was already a chief physician . He need not care about the dignity of others anymore .
Similarly, Ling Ran did not have to concern himself with another person's dignity to reject performing a surgery he was familiar with .
Ling Ran only nodded gently and said, "All right . Ma Yanlin, continue to stitch the skin . Nurse Liu, bring me the MRI scan of the ring finger on the left hand . "
Ma Yanlin braced himself and continued to stitch the skin . His actions attracted sidelong glances from all the people around him .
Ma Yanlin was also uneasy . When he picked up the needle-holder, his fingers even quivered a little .
Ma Yanlin could not help but look at Ling Ran .
If a high-ranking, kind-hearted doctor had been in Ling Ran's place right then, he or she would have likely given a speech of around eight hundred words to comfort Ma Yanlin, so that he would not feel too nervous .
However, Ling Ran did not even look at Ma Yanlin . He just continued with what he usually did . He minded his own business and stared at the MRI scan as his mind wandered . Unlike the minimal details contained in an X-ray scan, the amount of information in an MRI scan was tremendous . So much so that many of the contents in a scan taken by the hospital for a normal patient would be generally summarized .
Doctors who knew how to read an MRI scan would receive much more information from an MRI scan than an X-ray scan .
Ling Ran was focused on reading the scan, and because of that, Ma Yanlin calmed down .
It was impossible for him to not calm down at that moment .
Being doctors meant that they would always encounter all sorts of accidents, and the way they handled those accidents was when they truly showed their skills .
Ma Yanlin was still able to recall all the various things he previously did in the operating theater . Suturing and debridement were operations he did the most . He had also performed incisions several times, which gave him more knowledge about the hand structure of a human body .
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Although the finger of a five-year-old was small, Ling Ran had also sutured ten children's tendons with the M-Tang technique before . The positions may be different, but the problems were similar . The skin, muscle, fat, and sensory signals provided by the other parts were also the same .
Ma Yanlin calmed himself, and he penetrated the young patient's skin gently with a curved needle .
He sutured seriously, and each stitch reached the standard just like when he was back at the Emergency Department .
If no one had taken note of Ma Yanlin's face, they would not have been able to tell that the sutures were done by a houseman when they observed his operation .
The doctors watching by the side looked at each other . They did not make a sound .
Suturing was a skill that became better with practice . However, normal doctors did not have a chance to perform any sutures for finger replantation surgeries . If they did not perform a sufficient number of surgeries of this nature, it was only natural that they were not skilled in it .
However, Ma Yanlin was a first assistant who had performed over one hundred cases of surgeries using the M-Tang technique . His familiarity with the surgery was not inferior to that of a senior attending physician . Whenever he performed surgeries with Ling Ran, suturing skin was just a normal part of the operation .
A person's spirit and focus was, no matter what, limited . A first assistant was valuable because he or she could support the chief surgeon and also take care of trivial matters . Ma Yanlin did not have the chance to show his face previously, but right then, he was remembered by the chief physicians and associate chief physicians in the Hand Surgery Department .
"Doctor Ling, the skin has been sutured . " Ma Yanlin breathed a gentle sigh of relief .
It would be a lie to say that he did not feel weak when he had to wield a needle in the presence of such a large group of significant people .
To put it bluntly, the chance of a resident doctor being picked out to join a large operation from a large group of residents in a tertiary Grade A hospital such as Yun Hua was as slim as being the ram chosen for tupping among a thousand other rams .
Ma Yanlin obtained the chance while he was still a houseman, and he seized it . He was already so excited that he wanted to be the ram used during tupping season .
"Then… carry out the debridement on the ring finger . " Ling Ran forced his way in and occupied the position of the chief surgeon .
Ma Yanlin could only squeeze his head in . His body was positioned sideways . He managed to grab himself a small space to begin his operation .
The little patient was currently lying on her back with both of her hands splayed opened . There was a group of doctors on each side, and the operating table was very cramped because of it .
Ling Ran and Fei Zhou occupied the position of the chief surgeon on each side . The scrub nurse occupied the space in the middle . The assistants just had to make use of every bit of space they could get as they did their job .
Ling Ran rinsed and cleaned up the wounded part on the patient's hand . He then pinched the finger's joint before he observed the finger closely for more than ten seconds . He quietly sighed and said, "The severed part is in the middle section of the finger's bone . This will require bone shortening surgery . "
After receiving bone shortening, that particular finger would definitely be shorter than other normal fingers . However, at that moment, they no longer needed to think about aesthetics anymore .
Human beings naturally hated to lose . Furthermore, only very few would be willing to admittedly accept sunk cost[1] . That was the time when a doctor's knowledge and rationality were required to come into play .
After bone shortening and wound recovery, the finger would look terrible . But without bone shortening, the only choice left was to amputate the finger .
That loss did not occur during the bone shortening surgery . It occurred the moment her eight fingers were crushed and severed .
The use of a doctor was to minimize the loss as much as possible, but the chances of having no loss at all were very slim . All in all, the words "recover to its former glory" were merely words that were pleasant to the ears .
Speaking based on probability, the average success rate of finger replantations was approximately 80% . The probability of reaching the "excellent" standard in hand functionality assessments was even lower .
Even if the evaluation on the functionality of the hand was rated "excellent", that rating would have been obtained based on how well a finger could move after it was severed once . The finger would not function in the same way as a normal finger, much less when compared with the finger of more agile people in the world . Long-term medication and rehabilitation were also indispensable .
It was pitiful for a five-year-old child to be in such a situation . But none of the doctors on the scene would slow down just because they wanted to pursue perfection .
In fact, for the sake of increasing efficiency, all of them implemented the surgical procedure of stitching only one artery and parts of the nerves, including Ling Ran .
Besides Ling Ran, the other chief surgeons were doctors who had stood beside the operating table for around twenty to thirty years . None of them strove for perfection anymore .
All decisions came with a price .
The price of speeding up the surgery may have been a finger or several fingers losing the probability of complete functionality . However, the price of choosing perfection may have been one or even three fingers suffering necrosis . The worst case scenario would be these fingers affecting the other fingers as well .
Weighing risks was what surgeons did at every moment of a surgery .
Perhaps that was the greatest difference between a surgeon and a pilot .
Both surgeons and pilots required strong practical skills as well as a great amount of knowledge, and they all needed to possess the ability to perform timely judgment . The difference was that pilots would try to avoid all risks while surgeons would only choose the risks that they could control the most among various risks .
"Needle-holder .
"Keep it steady .
"Give me a 12-0 . "
Ling Ran pushed on step by step . He basically did everything the same as he normally did during his usual operations .
Usually, he just needed around one and a half hours to replant a severed finger .
"The ring finger's done . " Ling Ran buried himself in his work . He only raised his head and looked at his watch once he completed the operation .
Actually, he did not even need to open his mouth . The others had already noticed Ling Ran's speed .
Right then, none of the other three teams' finger replantation surgeries were completed . As they watched Ling Ran complete the steps one by by one, the doctors watching by the side could not describe their emotions .
"Can you still continue?" Wang Haiyang had yet to complete his own sutures as well . He remained calm and inquired .
Ling Ran responded, "Yes . "
"I'll leave the thumb on the left hand to you . " Wang Haiyang had given Ling Ran the finger that he initially planned to give to Fei Zhou .
Fei Zhou kept his head lowered . He pretended not to know anything . He only comforted himself repeatedly in his mind . 'The quality of my finger replantation is much higher, the quality of my finger replantation is much higher…'