Chapter 329

Fang Ziye left the banquet hall and carefully considered Zhongnan Hospital Orthopedics' standing in the nationwide jianghu!

In the official comprehensive rankings released in recent years, counting from the front to the back, it would rank thirty-something; even Tongji Hospital and Peking Union Medical College Hospital have not been fortunate enough to reach the top ten.

The Sixth People's Hospital of Magic Capital happens to be a top-tier unit among the national Grade-A tertiary hospitals for orthopedics. Rumor has it the world's first limb replantation surgery was born at the Sixth People's Hospital of Magic Capital……

The world's first case — such fame?

Fang Ziye gradually calmed his state of mind.

Long ago, Master Yuan Weihong and Teacher Deng led Fang Ziye through psychological preparation: this world is vast, the jianghu is wide, and also very wonderful.

Jealousy will not make one progress; ignoring the gap and forcibly claiming one is good cannot make up for the height difference between different tiers.

Cherish each step as you go; the current Fang Ziye is still far from the time when he can consider increasing Zhongnan Hospital Orthopedics' nationwide jianghu standing. Fang Ziye is merely a Chief Resident, and during the Chief Resident period, he has his own tasks.

……

Fang Ziye went to the Emergency Department to take a look and discovered the patient transferred from Chi City had a very tricky situation——

They don't want to die, but they want the leg!

Classic long-segment thrombus formation after lower limb trauma; the patient sought further diagnosis and treatment and was transferred from Chi City to Zhongnan Hospital.

The reason for choosing Zhongnan Hospital first was because the patient knew someone at Zhongnan, and had heard Zhongnan's orthopedics strength was not bad, and an acquaintance had called other hospitals to ask but had not received an affirmative reply for the time being.

So they planned to come to Zhongnan Hospital first to take a look.

After seeing the patient, the first thing Fang Ziye thought of was not how to salvage the lower limb, but immediately shouting in the group: "Just encountered a very typical post-arterial-thrombosis 5P syndrome; those interested come to the Emergency Department Surgical Clinic."

"I'm only giving you ten minutes. @everyone." Fang Ziye directly called people in the bed-management doctors' big group.

This time, there were four graduating Doctors in total; Professor Han Yuanxiao's Group had no graduating Doctor Senior Brothers this year, so the Fellow Trainees in his group did not rush to the banquet hall to make up numbers.

Fang Ziye's fellow disciples — some were still in the banquet hall accompanying Senior Brothers with drinks; Fang Ziye also did not know who was free.

But this 5P syndrome was really too typical; not calling a Fellow Trainee over to see would be too much of a pity, so he just sent that one sentence.

When limb arterial embolism or thrombosis occurs, the characteristic manifestation is persistent pain (pain), accompanied by pallor of the affected limb (pallor), pulselessness (pulselessness), sensory abnormality (paresthesia), and motor impairment (paralysis) and other symptoms and signs. The first letters of these five symptoms and signs in English are all P, hence it is called the 5P sign.

Additionally, he privately @'d Guo Ruodun: "Xiao Guo, you're on emergency duty today; this physical examination opportunity is assigned to you first. Rush to the Emergency Department immediately to conduct the preoperative informed consent procedure."

"The patient currently has a certain willingness for surgery."

After doing these things, Fang Ziye then sent the patient's lower limb CTA results to Wu Xuanqi and Senior Brother Nie Mingxian first.

And asked for advice: "Senior Brother Wu, Senior Brother Nie, looking at this patient's current CTA results and appearance images, is there still a possibility of salvage?"

"The current physical examination results are……"

Wu Xuanqi merely has decent operations in vascular surgery; Fang Ziye's current state is about the same as Wu Xuanqi's — deciding whether to operate and going to operate is fine, but whether it is suitable and whether it meets routine surgical indications, Nie Mingxian actually grasps more thoroughly.

As for the matter of losing the genius label by asking others for advice, Fang Ziye never took it to heart; the more mature he became, the less important so-called genius and face issues became.

As long as it is for the patient's good, brings the patient a better experience, and makes his own work quality higher, putting this face at the doorway doesn't matter.

Fang Ziye could actually add points, spending several thousand points to add points to vascular surgery and arterial thrombosis-related theory, and could also reach Nie Mingxian's level.

It's just that Knowledge Points are really not abundant, and the application is not that much, so for the time being Fang Ziye is still reluctant to add points; if he had Knowledge Points, Fang Ziye would definitely prioritize Trauma Surgery specialty skills like Bone Transport Surgery……

Although Nie Mingxian has already gone back to read for his Doctorate, contact with Fang Ziye and Wu Xuanqi has not been cut off; especially after Fang Ziye took up the Chief Resident position again, just like Wu Xuanqi at Tongji Hospital, he often asks Nie Mingxian for remote consultation.

No other reason: generally, if this hospital's Chief Resident encounters similar arterial thrombosis, the first suggestion is amputation!

"Senior Brother Fang, what is the surgical method?" Soon, Guo Ruodun arrived at the Emergency Department, first asked the surgical method, then planned to write the risk items on the Surgical Informed Consent Form.

This is a kind of assessment of the bed-management doctor's capability; based on the surgical technique, it tests the corresponding theoretical basic skills. The Fang Ziye of the past also went through this; it's just that currently, Fang Ziye puts this kind of assessment more and more out in the open.

Guo Ruodun is Attending Zhang Zixi's Master's Graduate Student, first year of Master's this year, and is a classmate of Lin Yihuang whom Fang Ziye met before.

"Amputation surgery with lower limb arterial incision and thrombectomy as backup."

"Remember: talk more with the patient about amputation choices and risks; limb salvage surgery is only the backup plan. If the patient disagrees, advise the patient to seek transfer to another hospital." Fang Ziye gave instructions to Guo Ruodun while receiving Nie Mingxian's affirmative reply.

During the Master's stage, opportunities obtained are not many; each needs to strive for them in the training room.

As a Chief Resident, Fang Ziye has walked through thorns before; now he is also relatively generous — delegation relaxes a bit, but later when Fang Ziye checks the corresponding risk clauses, he will be stricter.

"Okay, Senior Brother Fang; I'll send it over for you to review in a moment. I type fast." Guo Ruodun boasted like Wang Po selling melons.

Fang Ziye put away his phone, then went outside the clinic room and explained in detail to the patient's family: "Your situation, I also consulted the vascular surgery teachers; that side's teachers' opinions differ slightly from the vascular surgery Chief Resident Doctor Liu's opinion just now."

"There is just this bit of a chance to try thrombectomy; if it can't be removed, then amputate — it won't add any cost."

"But if you don't want the hassle, our hospital's choice is only amputation; if you want limb salvage and want more affirmative assurance of limb salvage preoperatively, then you might have to go to other hospitals to inquire."

The patient and family at this moment had already seen some new messages on their phones; each of their complexions became a few degrees uglier.

The family put away their phone and asked in succession: "Doctor Fang, are you sure our case has a chance for limb salvage?"

"There's a bit; can only say there's expectation, strive for it."

"If we strive and succeed, limb salvage; if we can't strive it down, preserve life. Otherwise once the limb necroses, then infection or reperfusion injury occurs, it will be very troublesome……" Fang Ziye explained.

He guessed in his heart that this patient and family might have heard news that wasn't good through connections.

Of course it wouldn't be good — who would willingly create extra branches without reason?

If it weren't for Fang Ziye knowing Nie Mingxian and having some friendship with Wu Xuanqi, a general Trauma Surgery Boss and Vascular Surgery Boss would give the suggestion of amputation after consultation.

Once amputation indications exist, no one would lightly move out several professors to do limb salvage for you; Vascular Surgery professors also might not have free schedules.

"Okay, Doctor Fang, then we're willing to try." The family member was the patient's husband.

He replied, looked at his wife, repeated: "We'll try; Doctor Fang dares to say this, he definitely has at least some confidence……"

The patient's wife's expression of despair relaxed slightly; she nodded lightly……

……

After obtaining the patient and family's permission, the rest is preoperative preparation and arranging operating room matters.

The patient is newly admitted, not absolute super-emergency rescue indication like hemorrhagic shock, so it's impossible to immediately arrange an operating room regardless of everything; still need to do an emergency preoperative preparation, which takes a certain amount of time.

Although this also wastes a bit of time and increases the probability of limb necrosis, from the doctor's perspective, a safer whole surgical process is more important than single-item surgical quality.

Fang Ziye sent another message to the two Fellow Trainees asking about the atmosphere inside the banquet hall; the reply received was positive.

Fang Ziye then felt relieved.

Actually, Fang Ziye was overthinking things; with so many big shots arriving and exchanging favors, where was there any need for a fresh Doctor like him to manage it?

Even if Fang Ziye's thesis defense topic was a bit stunning, and the animal experiment model had enormous clinical significance — an unprecedented HK2 knockout animal model — even attracting the interest of several professors.

But he was still a junior after all; in their eyes, Fang Ziye might just be a middle school student with pretty good grades, who had now been admitted to the best high school with excellent scores.

But actually, for adults, if you haven't gotten into university, it doesn't count as graduation.

And for the top professors, if you haven't crossed the threshold from Associate Professor to Professor, you're still below the line...

When Fang Ziye brought Guo Ruodun intending to perform arterial thrombectomy for limb salvage, he didn't expect to be caught by Yuan Weihong.

The call came quickly: "Ziye, heard from Jie Han that you plan to bring someone to do thrombectomy for limb salvage?"

"You can't act recklessly on this?" Yuan Weihong's voice clearly carried alcohol, his tone admonishing.

Fang Ziye heard this, brows furrowing slightly, and asked: "Master, I've carefully discussed amputation risks with the patient; is a backup surgery of thrombectomy also not allowed?"

"Can only Vascular Surgery perform thrombectomy at our hospital, and no one else besides them can operate?"

After all, it's a leg.

Fang Ziye hasn't never done amputations, but those amputations were mostly due to mangled extremities. Without big shots participating, Fang Ziye could only amputate, not daring to expect limb reconstruction and limb salvage surgery.

But this is merely a 'soon-to-necrose limb' after thrombosis formation; amputating it lightly, from Fang Ziye's angle, is truly a pity.

"There's no such regulation, but? Ziye, being skillful and bold is fine."

"But if you fail to operate well, you'll give people ammunition. Although vascular incision technique belongs to the interdisciplinary field between Orthopedics and Vascular Surgery, that's Hand Surgery and Vascular Surgery."

"Cross-disciplinary operation failure will be mistaken for showing off and failing..." Yuan Weihong explained the crux to Fang Ziye.

"Master, I didn't think about showing off?" Fang Ziye corrected.

"But what you're doing originally has a bit of that meaning?" Yuan Weihong corrected again.

(Chapter End)