Chapter 126 Consequences of damage to recurrent nerve branches, thumb reconstruction

Author: Jiangbian Yuweng

Chapter 126 Consequences of damage to recurrent nerve branches, thumb reconstruction

Severed limbs generally have a good survival rate if they are operated on within six hours. The preservation environment is okay, and if the temperature is low, there is still hope within eight hours.

There are even cases that have been successfully rescued after more than 12 hours.

This man's four fingers were still pale and wrinkled more than 24 hours after they were replanted, which is a very bad phenomenon.

Only fingers that have lost their life look like this.

Doctor Shan carefully examined the patient and then asked about some postoperative symptoms.

For example, do your fingers hurt?

Have you paid attention to keeping it warm?

Did you follow the doctor's instructions after the surgery, etc.?

Zhou Can just stood at the end of the bed and listened.

When the doctor makes rounds, the order of entry and standing are very particular.

The right side of the patient is generally reserved for the director, who treats the patient, and the left side is reserved for the resident doctors. When the director makes rounds, there are usually multiple residents, and at this time, the position needs to be determined according to seniority.

The senior ones stand in front, and the junior ones stand in the back.

The head nurse usually stands in front of the bed to 'care for' the patient at any time.

The remaining seats at the end of the bed are reserved for unimportant people.

For example, regular trainees, interns, graduate students, advanced students, etc. These are all just standing at the end of the bed.

After Doctor Shan examined the patient, his face was quite solemn.

Others also felt the oppressive atmosphere.

Failure of the operation is a bad result for the patient and their families, as well as all the doctors and nurses.

"Can you show me your medical records?"

Zhou Can didn't come up with this limelight, but remembered a situation the teacher said.

He wanted to confirm the patient's basic condition before making further analysis.

The bed doctor is a somewhat oily young doctor, about thirty years old. Maybe he has gone through puberty, and his face has dark marks left after acne heals.

He just glanced at Zhou Can lightly without any response.

I'm afraid I'm still thinking in my heart, this stupid B-level Pearson, didn't he see that he was attending ward rounds? Who do you think he is?

"Bring me the medical records!"

When Dr. Shan saw the greasy man didn't respond, her tone seemed particularly cold.

Many doctors actually hate bureaucracy and red tape.

Because the patient cannot afford to wait or delay, and the condition cannot be treated in any way.

Doctors and nurses normally fawn over leaders at all levels and superior doctors, and everyone can understand that. They all want to be in a higher position and want more support and resources.

But absolutely no doctor likes bureaucracy.

Because this means high mortality and high accident rate.

The greasy male doctor was trembling with fright. He didn't understand why Doctor Shan was so angry?

He handed over the medical record with respectful hands.

"Please check it out!"

After Doctor Shan took it, he handed it directly to Zhou Can.

"If there is anything Dr. Zhou wants to know about, if it is not recorded in the medical record, you can ask questions at any time."

By doing this, she was almost publicly supporting Zhou Can.

"Thanks!"

Zhou Can took the medical record and read it carefully.

While the patient was operating iron wedges with his coworkers, four of his fingers were cut off due to improper handling by the coworkers.

After the accident, he was immediately sent to the local social hospital.

The doctor simply bandaged the injured person's wound and provided the patient with an ice pack to refrigerate the severed finger. He suggested that they go to a large hospital immediately for replantation of the severed finger.

So I drove to Tuya Hospital.

After receiving the diagnosis, Director Shen led a team to perform replantation surgery on the patient's severed finger.

At that time, in order to shorten the operation time, Dr. Shan and Director Shen replanted the patient's severed fingers at the same time. One person replanted two severed fingers. Director Shen completed all the bone grafting of the four fingers.

She mainly performed tendon anastomosis, blood vessel anastomosis and nerve anastomosis on the patient's two fingers, as well as suturing the cortex of the severed finger.

The whole operation went very smoothly.

At that time, the blood supply to the four fingers was tested and all were smooth.

After Zhou Can read the medical records, he walked to the bed and carefully looked at the patient's palms and backs.

I saw multiple bruises on the back of his hand near his wrist and near the tiger's mouth.

"When you communicated with Dr. Shan just now, you mentioned numbness in your thumb, right?"

"That's right! When I was first injured, I thought the pain was so painful that I couldn't feel it. After the operation, I thought it would be fine after waking up from the anesthesia. But to this day, my thumb still feels numb."

The patient truthfully described his true feelings.

Zhou Can nodded, took a straw from the metal cabinet beside the bed, and touched the patient's index finger near the palm.

"Do you feel it?"

"A little bit, but it seems to be separated by a layer of clothes."

The patient's educational level was limited and the description was not very specific.

The metaphor is quite vivid.

Zhou Can tried his other three fingers in turn, and they were almost the same.

It feels very dull and extremely insensitive to the touch.

Having reached this point, Zhou Can basically had confidence in his heart.

He picked up the film taken by the patient and watched it carefully.

Doctor Shan waited patiently. Even if the other doctors were a little dissatisfied with Zhou Can, they had no choice but to be patient.

"Doctor Shan, do you think the injured location on the back of the patient's hand is the recurrent branch of the median nerve?"

"Yes! The reverse branch of the median nerve is approximately at this location."

She nodded.

Then, his eyes became brighter little by little.

There was also an expression of sudden realization on his face.

"You mean, the median nerve is damaged, so the blood supply is affected?"

Doctor Shan's expression at this moment did not look like he had a cold and serious treating demeanor.

He is clearly a happy child who has found the answer.

The solemn expression before had long since disappeared.

"I didn't say it, you said it." Zhou Can blinked.

"Haha, if you can find out the reason for the poor blood circulation of the severed finger, you will at least have a great contribution."

Doctor Shan rarely smiles.

At this moment, Zhou Can was sensible and gave her enough face and gave up all the credit to her. This made her very happy and useful.

"Mr. Gao, now we suspect that this part of your body was injured, and it may have injured a nerve. Nerve cells are the only cells that cannot be regenerated. Therefore, if the nerve damage is serious, we may not be able to do anything. Now we will order you two tests first.

Focus on checking whether the nerve pathways are interrupted and whether there is hematoma in this area."

"After thorough investigation, we will formulate a new treatment plan for you and try our best to preserve the fingers and hand function of your hand."

She communicates with patients and leaves room for everything.

And let patients make their own choices.

Zhou Can secretly learned and absorbed the communication skills.

In addition to striving to improve diagnosis and treatment, doctors also strive to communicate with patients as a required course.

"Doctor Shan, please tell me, is there any connection between nerve damage and poor blood circulation in the replanted severed finger?"

The medical level of the greasy male doctor should not be very high.
To be continued...