Doctor: I Can Synthesize Infinite Entries

Chapter 27: Chapter 27: A Crazy Thought, Wu Ting’s Repair Plan

In the emergency department corridor, Captain Huang Yangming called his superior, the chief of the Fan City Police Department.

After hearing about Liu Ping’s situation, the chief took it very seriously. With his connections, he was naturally able to contact the top experts in Jin Province right away.

”Yangming, here’s the plan. I’m going to call Dean Zhang at Jinggang University Affiliated First Hospital right now. I’ll have him arrange for an expert to come over as soon as possible. Once I’ve spoken with him, I’ll send you the number, and you can contact him for the details.”

”And as for City First Hospital, I’ll also call their Dean Tang and tell him to give his full cooperation to the expert from the province.”

”Rest assured, I’ll handle this. We can’t let our officers feel disheartened. Once Officer Liu Ping has recovered, I’ll apply for a personal Second-Class Merit for him. I’ll also apply for a collective Third-Class Merit for the entire unit involved in this operation!”

Hearing the chief’s arrangements and promise of commendations, Huang Yangming felt a measure of relief on Liu Ping’s behalf.

A few minutes after he hung up, the chief sent over a phone number.

Huang Yangming immediately dialed the number. The person who answered was, in fact, the dean of Jinggang University Affiliated First Hospital.

After learning the details, Dean Zhang had already contacted Professor Shen Guofeng, the head of the Emergency Department at Jinggang University Affiliated First Hospital. The professor had extensive clinical experience with this kind of limb reattachment surgery.

Shen Guofeng, M.D., Ph.D., doctoral supervisor, current Director and Editor-in-Chief of the *Jin Country Critical Care Medicine Journal (Electronic Edition)*, a Young Member of the Traumatology Branch of the Jin Country Medical Association, President of the Jin Province Traumatology Medical Association...

He had published over 100 papers in academic journals at home and abroad, with more than 40 indexed by SCI (all as either first or corresponding author). He had also served as editor-in-chief or associate editor-in-chief for 21 monographs and textbooks, and was the editor-in-chief and head of the ”11th Five-Year Plan” national textbook project, *Modern Cardiopulmonary and Cerebral Resuscitation*...

He had also won numerous provincial and ministerial-level awards; his skills and prestige in Jin Province were second to none.

If a high-ranking official hadn’t intervened this time, someone of Shen Guofeng’s status would never have come to Fan City First Hospital for an inter-hospital operation.

”Captain Huang, rest assured. I’m already on my way to Fan City First Hospital. I am quite experienced with limb reattachment surgeries. While I can’t guarantee Officer Liu will recover completely, I am confident I can restore basic function.”

Shen Guofeng certainly had the confidence to back up his words. In the entire Jin Province, he was one of the top five surgeons for limb reattachment.

Jinggang University Affiliated First Hospital took in countless difficult cases from across Jin Province that other city hospitals couldn’t handle. Because of this, Shen Guofeng’s clinical experience was at the apex of the entire province.

Huang Yangming felt a little more at ease after hearing Shen Guofeng’s words.

”That’s wonderful, Professor Shen. I’m waiting for you in the emergency department at City First Hospital. The doctors here are already performing the initial procedures on Liu Ping. We’re just waiting for you to arrive and take the lead on the surgery.”

...

...

「Inside the operating room.」

At that moment, after a discussion between Lu Xiong and Qin Donglai, they decided to start by administering a routine brachial plexus nerve block to Liu Ping and applying a pneumatic tourniquet to the affected limb.

”Dr. Qin, you and the team can start by thoroughly debriding the patient’s wound.”

As the attending physician, Lu Xiong took direct command of the operation.

”During debridement, be careful to protect the larger subcutaneous veins. Once you’re finished, I’ll proceed with the appropriate shortening of the fractured ends of the ulna and radius...”

”Scrub nurse, locking plates for fixation...”

Lu Xiong gave his orders methodically, all while observing the patient’s wound.

”Alright, let’s start with repairing the patient’s blood vessels and nerves...”

”The damaged vessels in the affected limb will require vascular grafts for bridging repair...”

”For the nerves, we’ll use epineural and large-bundle interfascicular anastomosis to repair the median, ulnar, and radial nerves...”

Lu Xiong explained his thought process to Qin Donglai. Luo Ming and Wu Ting were only expected to assist.

”But the biggest problem now is repairing the tendons. That’s the most critical part for restoring hand function later on.”

Lu Xiong could come up with a plan for tendon repair, but he knew it wouldn’t be the optimal approach.

’I wonder what the status is on Captain Huang’s expert from Xiao City. If we don’t decide on a tendon repair plan now, we can only do the vascular and nerve repairs first. But if we do that, we won’t be able to plan the optimal debridement incision...’

Lu Xiong sighed. Failing to design the entire surgical plan in one go would leave potential complications. They might even have to redo their work once the outside expert arrived.

For a moment, the operation stalled.

”Director Lu, Dr. Qin, what’s your estimate? If the expert from Xiao City left immediately, how long would it take for them to get here?”

Just then, an unexpected voice broke the silence.

Lu Xiong, somewhat surprised, glanced at the young man beside him.

Qin Donglai, on the other hand, was accustomed to Wu Ting’s blend of boldness and attention to detail. He didn’t find it presumptuous and replied:

”Given the distance from Xiao City to Fan City, it’s an hour and a half, minimum. Add in pre-op prep and planning, and we’re looking at a conservative estimate of two hours before they could even start the surgery.”

Lu Xiong nodded in agreement. He understood perfectly well why Wu Ting was bringing up the timeline.

Sure enough, Wu Ting followed up with a bombshell:

”It’s been a while since the patient was injured. They didn’t take him straight to Xiao City; they came to the nearest hospital, City First Hospital, to maximize the chances of saving the limb and recovering function. If we wait for the expert from Xiao City to take the lead, we’ll definitely miss the optimal window for treatment.”

’With his [Grandmaster of Tendon Suturing (Black)] ability, Wu Ting was absolutely certain. When it came to tendon repair, he was the most skilled person in the room. It was even likely that the incoming expert couldn’t compare to him.’

This was no time for Wu Ting to hide his true abilities.

”But Director Huo and Director Lin are still in surgery. That other patient’s condition is far more critical than Officer Liu’s—it’s a matter of life and death. They definitely can’t break away to operate, not even to provide remote video guidance.”

”With the team we have now, we can’t come up with an optimal plan for the tendon repair.”

Qin Donglai looked somewhat ashamed.

Lu Xiong remained silent as well. Vascular repair wasn’t exceptionally difficult, and nerve suturing was his specialty, so that wasn’t a major issue. But when it came to tendon repair, he truly wasn’t confident.

”No, we do have one. I have an excellent plan for the tendon repair.”

”Director Lu, Dr. Qin, we’re running out of time. I’ve recently put a great deal of effort into studying tendon repair for severed limbs, watching and learning from a massive number of surgical videos. Now, I’m going to lay out the treatment plan in detail.”

”I need you both to trust me. Please, wait until I’ve finished my full explanation before you raise any questions.”

Wu Ting’s confident demeanor convinced Lu Xiong and Qin Donglai to hear him out.

Luo Ming, standing to the side, was horrified. ’In a situation like this, a mere resident dares to speak so recklessly?’

But Wu Ting gave no one a chance to interrupt. In the field of medicine, technical expertise is what matters.

’He believed that even if Lu Xiong and Qin Donglai weren’t skilled enough to perform the procedure themselves, they still had the discernment to recognize a superior plan.’

”Director Lu, Dr. Qin, Dr. Luo, we need to begin with longitudinal debridement incisions through the palmar and dorsal skin and fascia...”

”For the main approach, I propose using a two-plane Kessler technique to suture the tendons, matching the repair to the thickness, depth, and morphology of the severed ends...”

”With this technique, the sutures form a cross-pattern inside the corresponding tendons, and the ends will be further reinforced with a figure-of-eight stitch...”

”Then, for areas with severe tendon loss, I’ll perform an autologous tendon graft, using the palmaris longus tendon, which is the most common choice for a donor tendon...”

”In conclusion, using a two-plane Kessler tendon suture technique, combined with fixation that alternates with the angle of finger flexion and extension, is the optimal procedure for treating this forearm transection. Tendon adhesion will be minimal, the patient can begin rehabilitation early, and the prognosis for functional recovery is excellent!”

”So, doctors, what do you think of this tendon repair plan?”

After Wu Ting finished his detailed explanation, the operating room fell silent.

Qin Donglai and Lu Xiong’s eyes were wide with disbelief. They exchanged a look.

Qin Donglai gave a tentative nod. Lu Xiong nodded back in response.

”I agree.”

”I agree as well.”