Chapter 158

"Huh? That doesn't seem right." At 3:10 PM, when the third surgery was already nearing its end, Fang Ziye stood at the suturing position, and while suturing the surgical incision, Wu Guo Nan, who had stepped down, glanced in Fang Ziye's direction as he took out his phone, and let out a soft "Huh."

Then he put his phone behind his back, clasped his hands behind him, and approached the operating table again, carefully watching Fang Ziye's suturing process.

The forceps lifted lightly and twisted slowly; needle entry and insertion were decisive and swift; threading and passing the needle showed no hesitation, and the knotting speed was also incredibly fast.

Fang Ziye merely glanced at Wu Guo Nan, then continued his own suturing operation.

Currently, the operation Fang Ziye worries least about going wrong is suturing technique and manual reduction technique.

With Level 4 proficiency, no matter how poor, even if placed anywhere, I do a suture closure, what can you say? It's not hand surgery's meticulous microsuturing.

Xue Tao, hearing Wu Guo Nan's surprised and doubtful sound, also confirmed his inner thought, saying: "Right, Director Wu, you noticed it too? I just thought I was seeing things."

"Ziye's suturing skill has some substance to it."

Although Enshi Central Hospital doesn't have a professional hand surgery sub-specialty, Wu Guo Nan happens to be in the trauma center, leaning toward the hand surgery sub-group.

Therefore, Wu Guo Nan's observation of suturing technique capability is the most meticulous.

In a prefecture-level city hospital, doing hand surgery operations, the requirements for suturing technique aren't that high; basically as long as small artery suturing is achieved, vascular patency rate reaches over 90%, and vessel diameter narrowing doesn't exceed 10%, no turbulent blood flow is produced, one can get started.

Save the hand first, then talk; as for whether function can reach the level of a top-tier hand surgery department, that depends on luck.

Actually, most hand surgery limb replantation operations, even if done extremely well, functional recovery is still quite limited, impossible to fully recover to peak level.

This point is profoundly reflected in a doctor predecessor in Eastern Han who was injured.

Once a doctor's hand is injured, it's hard to get back on the operating table again.

"Should be much better than me." Xue Tao looked carefully a few more times, got Wu Guo Nan's acknowledgment, then said firmly again.

"Haha, hahaha." After watching Fang Ziye operate two more stitches, Wu Guo Nan laughed unrestrainedly.

Then he raised his head and said: "Xue Tao, look, what did I say? You didn't believe me before, do you believe now?"

"This is the real deal suturing technique, the suturing skill usable in fine microsuturing."

"You're still slightly lacking in fire." Wu Guo Nan was very happy.

Good fellow, Director Zhang Mingcan sent a doctorate over to "gild" himself, didn't expect he'd actually hit my sweet spot.

Hand surgery inside Enshi Central Hospital has always been a shortcoming.

Enshi Central Hospital's orthopedics strength relies on spine surgery, joint surgery, and minimally invasive sports medicine to prop it up; trauma surgery is slightly lacking, hand surgery even more so, only one sub-group.

Trauma surgery strongest is Minzu University Hospital, hand surgery relatively strongest is Enshi People's Hospital, each has its own specialty!

Xue Tao didn't speak.

But Fang Ziye has also seen Xue Tao's suturing; proficiency is middling, not as good as Level 4, but proficiency is at least higher than a doctorate like Luo Tingzhu, around Level 3 300-400 proficiency, at a similar level to Yang Wenzheng in Zhongnan Hospital.

And Xue Tao's age is much older than Yang Wenzheng; after all Xue Tao is two or three years older than his own teacher.

For trauma surgery, it's definitely sufficient, but to advance into hand surgery, hasn't even reached the baseline of a prefecture-level city hospital.

As for Fang Ziye, currently wants to reach Zhongnan Hospital hand surgery's baseline, might still lack a bit of proficiency and vascular anastomosis level, but in a prefecture-level city hospital, can be pulled in and used directly!

"Very good, not bad." Wu Guo Nan smiled knowingly, then left the operating room first, but at the operating room doorway, turned back to look at Fang Ziye once more.

"Very good, very good." Again he murmured these few words in a low voice.

After Wu Guo Nan left, Wang Zhongxing blinked and said: "Tao Ge, what kind of freak is Ziye?"

"Manual reduction technique done this well, suturing technique can still be this awesome, and doing a closure is so smooth, did he start learning from the womb?"

Wang Zhongxing's age this year is around thirty-two or three; actually he's been promoted to attending physician for four or five years, just his education isn't that high, only undergraduate, so he needs seven years as attending to be eligible for promotion to deputy chief physician.

Wang Zhongxing envies Fang Ziye's clinical operation immensely.

In prefecture-level city hospitals, education is somewhat valued, research aspect is not valued at all. Only technology is the greatest core competitiveness.

Because everyone's education is like this, comparing back and forth, it's just short people comparing height.

In research field, everyone avoids it, fearing being targeted.

Only technology is a topic everyone often discusses.

Fang Ziye only replied now: "Overpraised, Xing Ge, just learned a bit from teachers, but that's it, not that exaggerated."

"If you guys went to Zhongnan Hospital's hand surgery, you'd know I don't even have qualifications to get on stage."

Fang Ziye rotated in hand surgery; Zhongnan Hospital's hand surgery, not even mentioning Professor Ni Yaoping, just Associate Professor Guan Qiquan, could probably lead the entire trauma surgery department by the nose in suturing technique.

Specialization in one's field; a shut-in wanting to race Bolt in sprinting, unless mutated.

But Bolt wanting to compare 2D culture with a shut-in, probably also a head full of question marks.

"Can't calculate it that way, you still have to look at age, Ziye how old are you, if you switch to hand surgery, I estimate Zhongnan Hospital's professors would welcome you eagerly, right?" Wang Zhongxing isn't easy to deal with, hit the key point.

Fang Ziye returned a bashful smile.

"See, I was right, right." Wang Zhongxing still a bit smug.

But at this moment, Xue Tao looked at this simpleton Wang Zhongxing as if looking at a fool; no wonder you haven't got a girlfriend in your thirties, serves you right.

Fang Ziye continued suturing.

Actually, through longitudinal comparison with knowledge points from earlier, Fang Ziye discovered that after his suturing technique upgraded to Level 4, the knowledge points gained from suturing not only didn't increase, but slightly decreased sharply.

Although the reduced quantity isn't much; previously completing one incision suture gave 3 points, now it's 2.5 points; this may be related to disease type difficulty and surgery size.

But Fang Ziye knows, logically, after his suturing technique upgraded, the contribution rate to wound recovery should be higher, right?

What principle is this?

Could it be, the higher level one's suturing technique, the more knowledge points get reduced instead?

Then what the hell is the use of upgrading skills to higher levels?

Fang Ziye just thought this briefly.

……

One surgery ended; during the fourth surgery, Fang Ziye performed an open manual reduction on the operating table.

Fracture treatment principle is reduction, fixation; this is the key operational step.

The reason for surgery is to hope that under open reduction, steel plates and screws or intramedullary nail internal fixation can be used to make fracture reduction better and fixation stability higher.

Therefore, the manual reduction technique remains easy to use even after the fracture has been exposed through incision.

For example, in the previous several surgeries, Xue Tao and Wu Guo Nan performed open reduction under supervision, reducing five or six times and fluoroscoping five or six times before achieving the standard of anatomical reduction, and during this process they would also utilize Kirschner wires for temporary fixation, as well as reduction tools like levers.

However, during the fourth surgery, when Fang Ziye stood at the operating position for manual reduction, he only reduced twice and fluoroscoped twice before the fracture ends fitted together.

Seeing this, Wu Guo Nan hurriedly said rapidly: "Don't move, you don't move!"

This tone was extremely anxious; while speaking, he held an electric drill with a 2.0mm Kirschner wire and rushed up to the operating table.

Fortunately there wasn't a cheap line like "I'll go buy you a few oranges."

After two Kirschner wires were crossed for temporary fixation, the circulating nurse pushed the C-arm machine for intraoperative X-ray fluoroscopy photos to the bedside; everyone in the operating room all left the operating room, going to the isolation room next door or outside the operating room, only then preparing to press the photo button.

At this time, there happened to be a little rookie nurse from the adjacent operating room, probably anxious or something, possibly an intern, who had never seen this scene, so she continued to accelerate forward.

Xue Tao hurriedly reached out to block her: "Little Sister, don't run, we're taking X-rays here, there's radiation! Stop for a moment."

One mention of radiation scared the girl pushing the cart at a jog; she hurriedly threw her buttocks back, only then grabbing the cart; after the cart steadied, she hurriedly turned and jogged another two operating-room lengths, only then pressing tightly against the wall, her eyes revealing a look of terror.

But actually, just as she turned to run back, this side had already pressed the photo button.

The X-ray machine indeed has radiation, but the operating room doors are all lead-plated doors that isolate radiation; the reason for warning her was to keep her from facing the operating room directly.

Radiation isn't a heat-seeking missile.

After fluoroscopy, the circulating nurse went into the operating room first, while Wu Guo Nan and the other orthopedic doctors were very carefully examining the films.

Examining films is to assess the degree of reduction.

Of course, it's not just one shot; if the first shot shows good reduction effect, you still have to rotate ninety degrees and take a lateral view, observing the reduction degree from more angles.

After all, post-fracture displacement has at least two directions of lateral and angular displacement — anterior-posterior and left-right — so only when the fracture aligns neatly in both directions does it count as a relatively successful reduction effect.

The anesthesiologist and circulating nurse both understood the situation well, so they didn't move at the first time.

In the distance, that little nurse pushing the cart to other operating rooms hurriedly tiptoed pushing the cart; watching her reach the orthopedic operating room doorway, she suddenly accelerated — knife sounds, sizzling sounds.

The friction sound of rubber slippers against the floor was exceptionally piercing, making people unable to help but laugh.

However, Wu Guo Nan and the others didn't laugh either; outsiders don't understand orthopedics' C-arm machine, so naturally they avoid it like the plague.

Soon, the circulating nurse adjusted the C-arm machine's angle, and after coming out to a relatively safe position, the lateral view photo came to a conclusion...

"The reduction effect is very good, basically achieving anatomical reduction, and the fracture line is hidden."

"Ziye's manual reduction skill can directly perform full fracture surgeries now, just that his professional title is a bit low, currently he doesn't have surgical permission."

"Right, Xue Tao?" Wu Guo Nan communicated with Xue Tao in a steady tone.

Placing Fang Ziye in an equal position, without making a fuss, as if feeling Fang Ziye naturally ought to be able to do fracture surgeries.

Fracture treatment, whether surgery or manual reduction, reduction is actually the most most most most critical step; as long as reduction is done well, then whether plaster external fixation or internal fixation instrumentation internal fixation, they are all relatively proceduralized operation steps and processes.

"Yes, the most essential point of trauma surgery treatment is manual reduction; this is just like, currently the most essential point of bone tumor treatment lies in the exquisiteness of the chemotherapy regimen."

"Good manual reduction means eating both big and small." Xue Tao finally, in front of Fang Ziye, said the daily dirty joke.

Speaking of it, recently because of Fang Ziye this new Doctor just arriving, he and Wu Guo Nan and the others had already pretended to be serious for several days.

Fang Ziye glanced at Xue Tao a few times, thinking: Is this something a young person like me should hear?

"What's 'eating both big and small' mean?" Wu Guo Nan was really bad; looking serious on the surface, probably when he tells jokes he's also full of bad water in his belly.

The circulating nurse's face flushed red in a flutter, but the instrument nurse, looking quite pretty, instead smiled: "Director Wu, I'm going to tell Sister-in-law on you, saying you play very wild."

"You've played too, or what?" Surgical process fast, surgical quality good, surgery ending early, Wu Guo Nan's mood couldn't be more relaxed.

This instrument nurse driving him, when his mood reached its peak, still dared to talk back — isn't that asking for discomfort herself?

The instrument nurse was a woman after all, not good to bicker with Wu Guo Nan face to face; she lowered her head, hugged her chest, and went into the operating room with knife sounds.

Subsequently, Fang Ziye deservedly got another chance to put on a steel plate and drive screws.

This is the flexible application of orthopedic internal fixation instrumentation operation experience.

One rely, two attach, three clamp; after the steel plate stably fits against the bone end, examining the fracture line must horizontally span three screw holes above and below; after the principle of at least three screws for fixation, Fang Ziye began drilling holes by formula.

These steps are all operable in the training room, only, when measuring depth.

Because in the training room, all screws are customized, so there's no step of measuring screw length.

Watching Fang Ziye apply the depth gauge very unproficiently, Wu Guo Nan finally found a joke point: "Looks like our Ziye is still a bit pure, has no experience in measuring people's depth."

"Should be not poked much."

Fang Ziye cursed inwardly: Can we not make everything a dirty joke, ah?

However, Fang Ziye also knew, the more relaxed Wu Guo Nan's mood, the more opportunities he himself would have.

"Right, Director Wu, the holes I usually play with are originally there. Not newly opened." Fang Ziye flexibly used the joke he learned in Zhongnan Hospital.

Wu Guo Nan and the others don't have an absolute master-disciple relationship with him, so why should he hold back?

Even if saying he himself is a bit dirty, that's also the teachers teaching badly; near ink one becomes black.

Of course, looking at Wu Guo Nan and the others' thoughtful expressions, then looking at the circulating nurse and instrument nurse hearing Fang Ziye's words, their incredulous expressions, Fang Ziye also felt, so this is what being a joke-teller feels like ha.

"Good fellow!" After a long while, Wu Guo Nan finally relaxed.

"This reaction ability is really strong."

Fang Ziye finished measuring depth, while saying to the instrument nurse: "54, give 55 screw."

This is mm, omitting the unit, convenient for communication.

After speaking, Fang Ziye said to Wu Guo Nan: "After all it's soft."

This line is what Fang Ziye learned following his own teacher, he's the one who corrupted him.

The original words were Yuan Weihong telling Qin Geluo: Clinical holes are all hard, none are as comfortable as soft ones, so you're not that smooth, right?

The atmosphere instantly reached a climax.

A group of people teased Fang Ziye again, saying Fang Ziye ah, serious on the surface, actually a belly full of bad water.

Some also said Fang Ziye definitely plays very wild, probably girlfriends are one batch after another.

Fang Ziye neither refused nor explained; he came here to avoid being fed things by people, a playboy label would instead make some people keep their distance, such a label is not unacceptable.

After the day's surgeries ended, Wu Guo Nan and Xue Tao both invited Fang Ziye to go eat dinner together, but it was still early; today was the department's big banquet, and timing-wise they still had to wait for Director Zhang Mingcan's arrangement.

Fang Ziye naturally agreed, saying okay.

However, Fang Ziye still said: "Director Wu, Director Zhang looked for me this morning about something, and told me to go find him after the surgeries ended. You and Director Xue and the others go back and rest first."

"I'll write the medical orders downstairs in a bit."

Of today's four surgical patients, the last one fell under Fang Ziye's supervision; therefore Fang Ziye had to perfect the postoperative medical orders.

Several people all nodded in agreement; Fang Ziye's professional capability was very mature, and he certainly wouldn't forget such a matter.

Then, Fang Ziye went first to the operating room where Director Zhang Mingcan was; the surgeries inside were still in progress, but because there had been prior instructions.

Therefore, Zhang Mingcan's student was waiting for Fang Ziye inside the operating room.

So, after Fang Ziye entered, although he ran into that 'Excellent Doctoral Senior Brother' at Min Da Hospital whom Director Zhang Mingcan had invited, he merely watched him perform a closed reduction in the operating room and did not stay for any further interaction.

Although Fang Ziye wanted to make contact, time-wise, it was not allowed.

After exchanging a round of pleasantries, Fang Ziye followed one of Zhang Mingcan's Master's student junior brothers, Guan Hongming, toward the direction outside the operating room.

Upon leaving, that Senior Brother Wu Xuanqi still looked at Fang Ziye with a smile and generously said: "Ziye, if there's an opportunity in the future, let's contact and exchange more. Don't be shy at all."

"Okay, Senior Brother Wu, as long as you don't mind me disturbing you." Fang Ziye turned back, waved his hand, and only then brought Guan Hongming toward the Anesthesiology Office downstairs to write medical orders...

(Chapter End)