Doctor: start with the heart

Chapter 27 Amputation?Zhao Xu's new plan!
"Yes, it would be very difficult for us to guarantee his life without amputation."

Looking at the battered middle-aged woman in front of him, Zhao Xu said with some regret.

"Doctor, can you think of another way? Xiaopeng is only 20 years old. If he loses his hands and feet, how will he survive!"

The middle-aged woman said to Zhao Xu almost beggingly.

"His hands and feet have been squeezed for too long and the cement has eroded, and most of the tissues have been necrotic. In order to save his life, he can only choose this option."

Zhao Xu said again.

Hearing Zhao Xu's words, the middle-aged woman's eyes suddenly dimmed, as if her life's hope was gone.

"Xiaopeng, why are you so stupid! Mom told you before that the webcast is harmful, but you don't listen to it, you don't listen to it!"

The middle-aged woman rushed to the bedside again and began to howl.

Seeing this, Zhao Xu really didn't know how to communicate with this half-crazed middle-aged woman.

At this moment, a middle-aged man walked in. He was wearing a blue overalls with oil stains on it, and he seemed to come directly from the workshop.

Seeing the miserable state of his son lying on the hospital bed, and seeing his wife crying, the middle-aged man suddenly felt a little dark in front of his eyes, but he still managed to calm himself down.

He took a deep breath and said to Zhao Xu, "Doctor, how is Xiaopeng doing now?"

"Is such that..."

Zhao Xu had no choice but to explain the boy Xiaopeng's condition.

"Oh, doctor, there is really no other way, must amputation be done?"

Perhaps because of being the head of the family, the middle-aged man was relatively calm, but he still asked with a glimmer of hope.

"If the limbs are amputated now, we can ensure his safety. If the necrosis of the legs and hands intensifies, by that time, even if the limbs are amputated, we will not be able to ensure safety."

Zhao Xu explained.

At this moment, Xiaopeng, a boy lying on the hospital bed, suddenly opened his eyes and said with difficulty: "Dad... Mom... No... Don't... Cut... Cut..."

Before he finished speaking, the boy Xiaopeng closed his eyes again and passed out.

"Xiao Peng!"

Seeing this scene, the middle-aged woman couldn't bear it anymore, she threw herself to the bedside with tears in her eyes, and cried out of breath.

"You have to make a decision. He can't even guarantee a clear consciousness now. This is because the endotoxin produced by the necrotic tissue has eroded to the brain. If we don't perform an operation, it will be really difficult for us to save his life. gone."

Zhao Xu sighed and said to the middle-aged man again.

"Doctor, let us think about it."

The middle-aged man sighed deeply and said slowly.

"Okay, but at most four hours, you have to make a decision."

Zhao Xu nodded and gave a final time limit.

"I see, thank you doctor."

The middle-aged man nodded, his eyes dimmed all of a sudden, he was already a bit hunched, but now he looked even older and stooped.

After coming out of the emergency room, Zhao Xu returned to the office.

As soon as he came in, he saw Wang Ming and Sun Chang were both sitting in the office with their brows furrowed.

"How? Did the patient's family agree to the amputation?"

Seeing Zhao Xu coming in, Sun Chang couldn't help asking.

"No."

Zhao Xu shook his head.

"Isn't this a joke? If he doesn't amputate, his life will be lost."

Sun Chang felt a little unbelievable.

"Parents' feelings, you will be able to understand when you become parents in the future."

Director Wang Ming shook his head, sighed and said.

"Xiao Zhao, have you explained everything you need to say?"

Director Wang Ming asked again.

"Well, everything has been explained clearly, and the family member has also signed the illness notification."

Zhao Xu nodded.

"Xiao Zhao, Xiao Sun, if the patient's family still refuses to sign the amputation after the deadline, what will you do?"

Director Wang Ming suddenly looked at Zhao Xu and Sun Chang and asked.

"Then it can only be treated conservatively. If you don't sign the contract, you won't be able to perform the operation. Life and death are your fate."

Sun Chang thought for a while and said.

"Well, Xiao Zhao, what about you? What are your thoughts?"

Regarding Sun Chang's answer, Wang Ming nodded, noncommittal, and asked Zhao Xu again.

Zhao Xu didn't answer right away. He was thinking about whether there was some way to save his life without amputation.

Suddenly, a flash of lightning flashed across his mind.

"Director, for this patient, we may change our thinking."

Zhao Xu said slowly.

"Oh? Change your mind, tell me about it?"

Hearing what Zhao Xu said, Wang Ming suddenly became interested.

Sun Chang also looked at Zhao Xu curiously, wondering what idea he had come up with.

"Yes, the main problem for patients now is that the necrotic tissue must be removed, and because the necrotic tissue is too large, the survival of other parts of the tissue cannot be guaranteed after removal, so we have to perform a complete amputation. Then we are It’s not possible to change the way of thinking, since the tissue has been necrotic, we will replace the necrotic tissue, so this problem will not be solved.”

Zhao Xu said very methodically.

"Replacement? You mean transplanting skin flaps? However, the extent of necrosis of both hands and legs is too large, and the skin tissue of other parts of the patient's body has also been eroded by cement, so there is no place to take flaps for transplantation."

Sun Chang said first.

"The skin flap cannot be taken by itself, so what about the heterogeneous skin flap?

Zhao Xu said again.

"for example?"

Sun Chang asked.

"I think it's possible to use a porcine axial flap for transplantation."

Zhao Xu expressed his thoughts.

The so-called axial flap means that there must be an axial artery and an axial vein (accompanying vein) parallel to the longitudinal axis of the flap in the flap. A complete set of regional circulatory system returned by the axial vein to ensure the nutrition of the skin flap.

To put it simply, the skin flap comes with a complete arteriovenous local circulation system. This kind of skin flap is easier to survive, but correspondingly, the number of blood vessels is more, and the difficulty of connecting blood vessels is even greater.

On the other hand, among all xenografts, the pig skin flap has the highest compatibility with the human body, and the survival rate of the recipient is also the best.

"Axial flap? If it is an axial flap, judging from the area of ​​injured and necrotic tissue in the patient's hands and legs, the difficulty of connecting blood vessels is unimaginable."

Sun Chang thought for a while and said.

"It is feasible to a certain extent, but Xiao Zhao, have you ever thought about it? This flap transplantation also has a success rate. If the transplantation is still unsuccessful after spending so much time and energy resources, then the limb will still have to be amputated in the end. This is very important for the patient. For the family members, it is a waste of money and a second offense."

Director Wang Ming said objectively.

"Let's leave it to the family to decide."

Zhao Xu said slowly.

"Well, Xiao Zhao, Xiao Sun, go and communicate with the patient's family members. Once the patient's family members agree to sign, they will cooperate with the burn department and transplantation department to operate immediately."

Wang Ming said very simply.

"I see."

Zhao Xu nodded solemnly.

"so be it."

Wang Ming stood up. If this operation is really going to be done, then the burn department must coordinate a surgeon who is proficient in flap transplantation. This requires Wang Ming to do it himself.

After Wang Ming left, Sun Chang couldn't help but sized up Zhao Xu, and said, "School brother, your way of thinking is really different."

Sun Chang sent this out of feeling. Zhao Xu thought of the surgical plan that she and director Wang Ming hadn't thought of.

"Let's give it a try, there are still many problems in the future."

Zhao Xu said with a sigh.

If it is a direct amputation, it is actually the simplest and most labor-saving solution for doctors.

On the contrary, if a transplant is to be performed, the patient's physical tolerance, later recovery, flap survival rate, and the nursing and economic pressure on the family are all very difficult issues.

"It would be great to have a try, let's go, let's talk to the patient's family."

Sun Chang stood up, patted Zhao Xu on the shoulder, and said with some relief.

At this moment, Zhao Xu's weight in her heart deepened even more.

(End of this chapter)