Dr. Chung’s 90s

Chapter 99 Upper arm separation and replantation

Although Officer Zhao is only a police officer in his jurisdiction, he has extremely strong investigative capabilities.

He saw the injured person's unusual trust in Dr. Zhong. However, things had priorities. The most important thing now was to save people, and other things had to be put on the back burner.

Although Guo Pengfei was also on duty today, it was not enough for him and Zhong Yu to perform the surgery alone.

While Zhong Yu was undergoing preoperative treatment, someone had already gone to notify Tang Jiaren and Cai Yizhong of their return.

The nature of a doctor's work is such that he is always on call [-] hours a day even on holidays.

After Zhong Yu's unremitting efforts, No. [-]'s vital signs finally stabilized.

Tang Jiaren and the others rushed back to the hospital as quickly as possible so that they could officially start the upper arm replantation surgery.

This operation needs to be performed in two groups at the same time. One group is Tang Jiaren and Cai Yizhong. They first soak the fractured limb in 1‰ Xinjierzao solution 3 times for 15 minutes each time. After taking it out, they clean it with normal saline, disinfect it with iodophor, and spread it as sterilely. Use a napkin, make incisions and reductions on the dorsal sides of the ulna and radius respectively, use 35mm diameter Kirschner wires to internally fix the broken ends of the ulna and radius, and then find the brachial artery, brachial vein, basilic vein, and head from the upper arm end of the severed limb. The broken ends of the veins are trimmed and marked for later use.

The median nerve and radial nerve were not trimmed but were marked for later use. The stump of the ulnar nerve was found along the direction of the ulnar nerve. If a brush-like change was seen, it was left untrimmed and marked. Then trim the necrotic and inactivated tissue and skin for later use.

Zhong Yu led Guo Pengfei's team to treat the patient's upper arm stump under general anesthesia.

After thorough debridement, find the brachial artery, brachial vein, basilic vein, and cephalic vein stumps in the cross section of the upper arm, trim them, and mark them for later use. Then find the radial nerve, ulnar nerve, and median nerve and mark them. Then trim the necrotic and inactivated muscles and wound edge skin.

After both groups were ready, the broken ends of the humerus were shortened by 15cm each using a wire saw, the shortened right humerus was reduced and fixed with a steel plate.

Zhong Yu continued to trim the right brachial artery. After both ends were satisfied, the ends were anastomosed with the naked eye using 11-0 non-invasive sutures.

Then loosen the non-injurious blood vessel clamp, and there will be no bleeding from the anastomosis. In about 2 seconds, the skin of the forearm of the affected limb becomes rosy, the blood supply to the fingers is restored, and the right radial artery is palpable and pulses strongly.

Director Tang and others watched intently, excitedly.

Zhong Yu saw blood oozing from the distal ends of the right biceps brachii, right triceps brachii, and right brachioradialis ruptures, and the arterial anastomosis was successful.

She then performed an end-to-end anastomosis of the brachial vein and loosened the blood vessel clamp. There was no blood leakage at the anastomosis site and the backflow was sufficient. The basilic vein and cephalic vein were anastomosed with the same method, both of which were successful in the first attempt.

The ratio of arteries and veins is 1:3. During the anastomosis, 12500 U of heparin saline with a concentration of 500 ml of normal saline was injected into the broken end of the blood vessels to dilate the blood vessels.

The two stumps of the radial nerve were sharply cut together, and the epineurium and perineurium were jointly anastomosed with 11-0 non-injurious sutures. They were relaxed and tension-free, and the median nerve and ulnar nerve were anastomosed in the same way.

She then carefully sutured the trimmed brachioradialis, biceps, triceps and subcutaneous tissue and skin separately.

One rubber drainage strip was placed on each dorsal wound of the ulna and radius, and two rubber drainage strips were placed on the replantation wound of the upper arm.

After the operation, Zhong Yu still did not let down her guard. She personally sent No. [-] to the single ward.

For better recovery of the patient, the ward must be kept ventilated and dry, and the room temperature should be maintained between 23°C and 25°C using a baking lamp.

After he lay in bed, Zhong Yu used intravenous infusion of 2g of ceftriaxone sodium, 200ml of ofloxacin, and 200ml of metronidazole to control the infection.

At the same time, she has to check her liver and kidney functions at any time to prevent poisoning reactions and multiple organ failure.

Zhong Yu arranged for Zhang Yunfei to stay temporarily for post-operative care, and told her to strictly follow the medication standards. She herself was always in a state of high concentration.

In fact, for patients with severed limb replantation, the first priority is to actively and effectively save lives. Secondly, after the vital signs have stabilized, replantation will be considered based on the condition of the limb injury.

Because the injury to No. [-]’s upper arm had not been isolated for a long time, she was able to gain time for thorough debridement.

She was careful, accurate and skillful during the operation. After the operation, she strictly controlled the room temperature, resolved vasospasm and thrombosis, controlled infection, prevented poisoning reactions, multiple organ failure and other key conditions for reimplantation.

After her hard work, No. [-]’s chance of surviving the re-implantation in her upper arm was greatly improved.

She didn't know what No. [-] had experienced during this period. His physical condition had deteriorated a lot. The most important thing was that it was difficult to anastomose blood vessels and nerves.

Zhong Yu must ensure the quality of the anastomosis and can only succeed once.

Fortunately, she has superb skills and has the help of the plug-in Resurrection Vine, and No. [-] trusts her enough to cooperate actively.

In short, the success of this upper arm dissection and replantation surgery was hard-won.

Zhong Yu only had time to deal with follow-up matters after the patient's condition stabilized.

It was already eight o'clock in the evening, and Officer Zhao never left.

As soon as Zhong Yu came out of the ward, he ran into him. He looked at Zhong Yu with scrutiny.

As a people's policeman, it is right to be suspicious of everyone when encountering emergencies, and Zhong Yu doesn't mind.

In addition to Officer Zhao, another policeman was also guarding outside the ward.

Zhong Yu motioned to Officer Zhao to come to her office for a detailed discussion. Officer Zhao did not hesitate and repeatedly asked his colleagues to protect the victim before leaving.

Guo Pengfei was having a heated discussion with Cai Yizhong about the details of the operation. When he looked up and saw Zhong Yu coming in with Officer Zhao, he immediately shut up.

The two knew that they had something to talk about and took the initiative to avoid going out.

Zhong Yu's expression remained unchanged. She politely invited Officer Zhao to sit down, and then poured him a glass of water.

Not only did the two of them just meet, but they also had a relationship with each other in helping the little boy find his mother, so Officer Zhao couldn't help but keep a cold face.

Zhong Yu had no intention of gritting her teeth and said straightforwardly:
  "Officer Zhao, I know that it is your duty, so I want to find out the relevant information about the patient with a broken arm. In fact, I don't know his name or what happened to him. All I can tell you is that I am very He will soon be transferred to the Military Region General Hospital."

Officer Zhao was puzzled as to why she suddenly brought up this topic. Zhong Yu didn’t wait for him to ask, and then said:
  "The patient with a broken arm was once my patient at the Military General Hospital. Because I was his attending physician, he trusted me very much."

Officer Zhao's head immediately turned around, and he asked in surprise: "Is it because he was performing a mission that he..."

Zhong Yu motioned him to shut up with sharp eyes and lowered his voice:
  "Although I don't know what the mission he performed is, I hope you can ensure his safety. It's best if this matter can be as if it never happened. I will also report this matter to the relevant leaders. I believe it will be done soon." Someone will take care of it.”

Officer Zhao never doubted Zhong Yu's words. He knew a lot about her and believed in her character. As a public official, he still had the ideological awareness he should have. He stood up and put on his hat again, and said with a serious face:
  "To be honest, we rescued him in a mixer at the construction site. Except for the escaped assailant, no one else was there at the time. There was no fanfare when he was brought to the hospital. Not many people knew he was here."

Zhong Yu nodded and said solemnly:
  "I would like to thank you for rescuing him. I will call and report immediately. I will follow instructions on what to do next." Officer Zhao said calmly: "Then I will go and guard him first."

Zhong Yu watched him leave, and she guessed that No. [-] was forced into the blender.

The assailant watched helplessly as his right upper limb was torn off from his upper arm by the blender. He must have wanted to kill him. If Officer Zhao hadn't appeared in time, he would have been smashed to pieces.

Zhong Yu didn't dare to think deeply. She picked up the phone and wanted to contact Dean Luo, but then thought that Ji Xueli seemed to have said that he would handle the related tasks on the [-]th. Instead of relaying it through Dean Luo, it would be better to contact Ji Xueli directly.

Ji Xueli was still discussing the patient's surgical plan. When the nurse came to call him, he was a little unhappy.

But when the nurse said it was Dr. Zhong who was looking for him, he stood up without hesitation and walked out with long legs.

He knew Zhong Yu's character, and if he asked him to answer the phone even though he knew he was holding a meeting, there must be something urgent.

Although he walked quickly, he was not blushing or out of breath when he arrived at the office. He calmed down and took the phone and said warmly:
  "A'yu, it's me, what happened?"

Zhong Yu felt a little at ease listening to his voice and said calmly:
  "I met No. [-]. He was pushed into a mixer and his right upper arm was torn off. He was rescued by the police patrolling the area and sent to our hospital. I just performed a replantation surgery on his upper arm. There is no surgery yet. I’m over the edge and I don’t know what to do next.”

Ji Xueli tightened his grip on the phone and said with an ugly face:
  "A'yu is obedient. Don't go to his ward unless necessary. Are the local police protecting him?"

Zhong Yu's chest tightened because of his words, and he calmly said:
  "There are people on the ward to protect him. His condition is unstable and I can't leave him to others to watch."

Ji Xueli took a deep breath and said calmly: "You stay in the office and don't go anywhere. He has just had surgery and there will be no problems for the time being. You wait for my call."

Although he didn't say much, Zhong Yu could feel his anxiety.

Ji Xueli hung up the phone and immediately called his superiors.

When the call was connected, he explained the incident concisely and clearly without any personal emotion. The person on the other end of the phone also immediately gave instructions. They would send more manpower to the rescue as quickly as possible and transfer No. [-] quickly. .

The military has already received the news that the mission on the [-]th has been completed and they have important evidence in their hands. The things he brought out during his narrow escape have not been handed over yet, so his safety must be ensured.

Ji Xueli had to tell his superiors that No. [-]'s current physical condition was not suitable for transfer. If he had to transfer, he would have to be accompanied by a doctor with excellent professional skills, otherwise he might lose his life at any time due to postoperative infection.

The person on the other end of the phone didn't seem to find this difficult. He said calmly:
  "Since it is Dr. Zhong who is treating him, let her be the accompanying physician to escort him. It will only last a day at most. As long as they rush back to the military area as quickly as possible, they should be able to escape the danger."

Ji Xueli's face was extremely expressionless, and he objected without hesitation:
  "Dr. Zhong is a young woman and has never been on a mission. Although her professional skills are excellent, she has no ability to protect herself. No. [-]'s life safety cannot allow any slight deviation. I apply for personal escort."

The leader on the other end was silent for a moment, "Isn't it too late for you to rush over?"

Ji Xueli said calmly: "I just finished the operation on the [-]th. It is not advisable to move within [-] hours. This time is enough for me to arrive in Haishi."

In the leader's mind, Ji Xueli was naturally more practical and reliable, but this mission was too risky, so he inevitably hesitated.

"Do you want to ask Chief Ji for permission first? After all, this mission is not easy."

Ji Xueli smiled nonchalantly and said in a relaxed tone:
  "Don't worry, leader. Chief Ji will not object. He would rather his son go on a mission than see his daughter-in-law take risks."

The superior leader across the receiver was stunned when he heard this, then started laughing again.

"Good boy! No wonder you are so anxious. Okay, do as you wish. Be careful not to rush into anything too greedy for success. Life safety is the first principle in everything."

Ji Xueli solemnly agreed. After hanging up the phone, he called Zhong Yu again. Before Zhong Yu left the office, Ji Xueli said in a short sentence: "Someone will be there soon to protect No. [-]'s personal safety. You don't have to worry too much about working as usual." Just try to go to his ward as little as possible, I will be there soon."

Zhong Yu said in surprise: "Why did you come here? Didn't someone take over?"

Ji Xueli explained softly: "The leader requested that No. [-] be transferred back to the military area. He needs accompanying doctors to ensure his life safety."

Zhong Yu subconsciously said: "It is most suitable for me to be the accompanying doctor!"

She did not shirk her responsibilities. The danger of this accompanying mission was obvious. Since she chose to join the Military General Hospital, she should take the initiative to assume the responsibilities she should bear.

Ji Xueli refused without hesitation: "You are not the most suitable candidate. You have no experience in missions, and you do not have strong physical fitness. If an emergency happens, it will hold everyone back. What you can do There are many things, but this one doesn’t work.”

His tone was firm. Zhong Yu felt as if someone had poured cold water on her. She would definitely encounter emergencies on the road. She didn't even have the ability to protect herself, so how could she take care of No. [-]?

She was not disappointed and said calmly:
  "Then please pay attention to safety on the road. I have prepared relevant medicines that may be used on Route [-] in advance."

Ji Xueli greatly appreciated her crispness, and the two hung up the phone and went about their business.

The people from the military region came very quickly, probably transferred from nearby. Officer Zhao breathed a sigh of relief after handing over to them.

After all, he was just a policeman in the area who dealt with trivial matters. He was suddenly asked to deal with such a difficult matter, which was quite a psychological pressure.

Ward No. [-] was quickly put under strict control. Except for Zhong Yu, no other medical staff were allowed to enter.

Zhong Yu simply didn't go home. She was the main person taking care of No. [-]. At around two o'clock in the morning, she took medicine to the ward to make an intravenous drip for No. [-]. No. [-] fell asleep and didn't wake up.

After carefully checking whether there was any infection in the wound, she told the staff on duty to always pay attention to the patient's reaction, and then turned and left.

Coming out of the ward, Zhong Yu had a look of exhaustion on his face.

She had been in a state of tension ever since she saw No. [-], and she had not let down her guard even until this moment.

As soon as she turned the corner, she met a strange female nurse head-on.

As soon as Zhong Yu got closer, he smelled the strong scent of perfume on her body. She was still wearing leather boots with heels, and her voice was particularly abrupt as she walked in the empty corridor.

Zhong Yu's sluggish mind immediately woke up.

Their hospital has clear regulations that medical staff are not allowed to wear perfume and wear high heels while working. Something doesn't look right about this woman.

Zhong Yu suddenly paused, her heart beating into her throat. Seeing the woman getting closer to the ward, she shouted loudly:
  "She is not a nurse! Please be careful..."


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