Signing in at the hospital, the first operation shocked the whole country!

click!

The door opened and an emergency responder jumped out.

"Quick! This unconscious one is injured in the back!"

"Move the bed! 1, 2, 3!"

The woman was carried to the hospital bed and pushed directly into the rescue room.

As soon as this ambulance drove away, the next one followed.

The hearts of all the doctors and nurses suddenly lifted.

Uncoated injury, here we come!

Chapter 150 Debate over surgical plans, who will be the surgeon?

click~

The second ambulance stopped and opened the door, and the emergency personnel jumped out and dragged the stretcher off.

"There are many fractures and degloving injuries to the feet. There are no abnormalities in the internal organs at present."

"it is good!"

Xiao Jing and all the doctors stepped forward and saw the little boy on the stretcher with a face full of pain, teeth clenched, trembling all over, already drenched in sweat.

On the exposed left foot, from the ankle bone down to the heel, the entire skin, muscles, Achilles tendon, and nerve tissue are all torn.

The stretcher was covered with blood, but the white bones could still be clearly seen.

Everyone frowned upon seeing this!

The skin from the dorsum of the foot to the ankle joint is peeled off in a large area, and the muscles and bones are exposed. This degloving injury is serious!

"Send it to the emergency room, debride the wound and stop the bleeding first, notify the imaging to prepare for CT, open the operating room, and prepare the blood in the blood bank. Quick!"

Xiao Jing immediately said to the nurse next to her.

"Come on! Move the bed! 1, 2, 3! Let's go!"

wow~

Immediately afterwards, the little boy was quickly pushed into the emergency room.

"Hmm~"

Xiao Jing frowned, and as soon as she touched the little boy's calf, she heard a muffled grunt of pain.

She looked at the little boy, her lips were bitten, and she refused to shout out.

"I'm going to clean your wound first. If it hurts, just call it out. Don't hold back."

Xiao Jing said to him.

But the little boy still bit his mouth tightly, shook his head vigorously and did not speak, but his eyes were full of tears.

Seeing this, Xiao Jing did not continue to speak. Tramadol was injected for epidural anesthesia, and she picked up normal saline to start simple debridement.

Then he was pushed into the CT room, and the little Jiang boy was carefully lifted onto the machine for a full-body scan.

quickly,

After the image came out, all the doctors in the emergency conference room began to consult.

So far, no internal organs have been damaged, and the main fractures are the tibia of the left thigh, the fracture of the tibia of the calf, and serious injuries to the feet.

It can be clearly seen from the CT film that the tibia of the little boy's left leg was directly broken in a staggered shape.

The calf was slightly fractured, the foot was extensively wounded, the fifth metatarsal was fractured, the left calcaneofibular ligament was completely ruptured, and the joint was unstable.

"Doctor Sun, tell me your opinion."

Xiao Jing looked at the male doctor in charge of orthopedics.

This kind of injury is in the category of orthopedics, so we still need to listen to their opinions first.

"Okay, let me talk about it first."

Dr. Sun of the orthopedics department nodded, straightened his waist,

"At present, the patient's condition is very clear. The skin on the mid-distal 2/3 of the foot and the skin on the sole of the foot are completely degloving and avulsed. In this case, our orthopedic department suggests that we can try to suture and not use the flap for the time being.

As for whether there will be necrosis in the later stage, it depends on the recovery situation. If necrosis occurs, I am afraid that the limb will have to be amputated. "

"I don't see it that way."

As soon as the words fell, the other doctor next to him shook his head and sighed.

"For this level of avulsion injury, the possibility of necrosis is very high. Moreover, the sole of the foot is not wear-resistant, and it will bring long-term pain to the patient in the later stage. I don't think it is necessary."

"Then you mean amputation?"

Xiao Jing frowned when she heard the words, and said in a deep voice, seeing the other party nodded, she immediately denied it,

"No, this child is only 7 years old, what should I do after the amputation?"

"But once the plantar necrosis occurs, the patient not only wastes high medical expenses, but also bears the pain of a second operation. Who will bear the risk?"

......

For a while, amputation and attempted restoration, the two opinions diverged.

indeed!

They are all right!

At present, the child's degloving injury situation is understandable even if he chooses to amputate.

But in fact he is too small!

Amputation will cause long-term pain in the future life, and even cause huge trauma to the body and mind.

And if you insist on keeping it, according to the experience of orthopedics, the repair of this level of avulsion injury and the later necrotic flap surgery are also a kind of suffering for the patient.

And it is impossible to completely restore it.

The blood supply of the skin and the cutaneous nerve were seriously damaged!

You must know that the skin on the bottom of the foot must have sensitive sensations. In addition to the general pain, temperature, and touch sensations, it must also have a higher physical sensation.

In addition, the subcutaneous tissue of the sole of the foot should be dense, so that it can be wear-resistant when bearing weight, walk stably, and maintain balance.

Avoid the formation of ulcers on the soles of the feet and on friction!

After debridement of the avulsed skin, suture in situ is not easy to survive, and although the survival rate of the replantation made of split skin is high, it is difficult to meet the special requirements of foot repair.

In other words, the biggest difficulty of this operation lies in the suture during the operation and the survival after the operation!

Each one is like a moat!

And if you want to succeed in both of these, it is tantamount to a narrow escape!

"How to do?"

Xiao Jing was also anxious. Now she had different opinions on the operation and could not make a final decision.

bang~

"Doctor Xiao, the family members are in touch."

At this time, the head nurse opened the door and came in and said.

Family members found?

Very good!

Xiao Jing's eyes were filled with joy when she heard the words, as long as the family members came, the plan would allow them to make a choice.

And the voices of everyone arguing also decreased, and they understood that the next choice would be the family members.

"How is the mother of the child?"

Xiao Jing looked at the head nurse and asked.

"Compression fractures of the lumbar 2 and 3 vertebrae, comminuted fracture of the right arm, mild concussion, and no other problems have been found so far.

The operation will be arranged in a short while, and the person will probably wake up soon. "

The head nurse explained the situation of the woman's injury, and Xiao Jing also breathed a sigh of relief.

Fortunately, the injury is not serious~

If the internal organs or brain were injured, it would be too tragic.

"Okay, everyone, let's finalize the two surgical plans, and let the family members come to choose later."

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

Everyone nodded and began to prepare two sets of surgical plans.

But who should do the first in situ suture?

After arguing with the orthopedic surgeon, he couldn't help beating his heart.

To be honest, if he were to suture such a degloving injury, the chances of survival were really uncertain, but as a doctor, even if there was a chance of survival, he would not want a child to lose a foot at such a young age.

So he still has to give it a try!

"I'll ask the director to come over and take a look."

Xiao Jing got up and said, then walked back to the office and called Zhou Xianren.

Seeing the child's injury, Zhou Xianren also frowned and fell into deep thought.

In this situation, if he were to consider it from a doctor's point of view, the possibility of amputation would be slightly higher.

But it is not that there is no opportunity for in situ suturing, but this has high requirements for the surgeon and later regeneration.

It even takes some luck!

"You can try in situ suture first, and finally consider skin flaps if necrosis really occurs."

Zhou Xianren pondered for a moment and said, he still denied direct amputation,

"The child is too young, no matter what, we still have to consider it from the perspective of human feelings. If there is an opportunity, try to give it a try."

"But who's going to take the lead?"

Xiao Jing nodded when she heard the words, which was consistent with his opinion, but the most serious question came.

The voice fell, and there was silence.

Yes!

This is a big problem!

The two directors of the orthopedics department are resting tonight, one of the two orthopedics attendings staying on duty is preparing for the mother's surgery, and the other one is here.

Seeing everyone's gazes, Dr. Sun shrank his neck suddenly, his expression a little embarrassed.

He can do this degreasing injury, but...

It's still a question of success rate!

"How about I call the director and ask?"

Dr. Sun from the Department of Orthopedics looked at Zhou Xianren and said.

"It's so late, it's not appropriate."

Zhou Xianren shook his head and refused, frantically filtered in his mind, and suddenly stopped on a figure, with a flash of inspiration in his eyes,

"I know one person who might be able to do it."

"You mean Director Qin?"

Xiao Jing on the side said immediately.

"Yes, Qin Feng hasn't left yet, he is busy in the general practice clinic, he can have this operation, the chance may be better!"

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

Qin Feng?

Everyone couldn't help but tremble when they heard this name!