Chapter 332

"Brother Zhaoyang, Doctor Fang is the Boss of Trauma Surgery; I just happened to pass by and ran into him. Doctor Fang might still have his own matters to attend to." Liu Faming hurriedly explained.

As fellow big fools, he couldn't let Fang Ziye be taken away just like that by his own department's senior colleague, delaying Fang Ziye's schedule.

Lu Chaoyang was evidently also familiar with the name Fang Ziye; after hearing the explanation he hesitated slightly, then smiled and explained his embarrassment: "Sorry about that, Doctor Fang. It's really not that I failed to recognize a true worthy — it's just that you're too young, Doctor Fang, so I thought you were one of our department's Doctors..."

Fang Ziye could find no fault with Lu Chaoyang's words; Fang Ziye's current age was exactly that of a Doctor in training.

Lu Chaoyang's politeness made Fang Ziye even more polite: "Thank you for the praise, Brother Zhaoyang. Actually I'm getting on in years too; I just look young..."

Lu Chaoyang then asked: "Does Doctor Fang have any other arrangements? To tell the truth, our department just received another patient with a lower abdominal hematoma. Earlier Teacher Qi did a temporary intervention in the Emergency Department, but the situation remains critical."

"I've been assigned to enter the OR first and stand by to take the case at any moment; we may need to perform an exploratory laparotomy for shock. The Professors and Associate Professors have all gone to meetings recently. If it's convenient for you, Doctor Fang, how about coming over to lend a hand..."

This day was a weekend, and precisely because it was a weekend, Fang Ziye's thesis defense could more easily summon many professors from the thesis defense committee.

Other professors having time to come to Han City on a weekend for their schedules already counts as busy; the Deputy Chief Physicians of Zhongnan Hospital having other out-of-province conferences or flying-knife surgeries on weekends is also perfectly normal.

No one can foresee an emergency and stand by twenty-four hours a day.

"Then I'll go learn a thing or two with Brother Zhaoyang." Fang Ziye replied.

No other reason — the knowledge points given by that Vascular Surgery patient friend who was inadvertently rescued last time were simply too many.

It seems that Vascular Surgery disease types are generally even more life-threatening than Trauma Surgery ones, so after corrective treatment they yield even more knowledge points.

Lu Chaoyang had no time to exchange pleasantries with Fang Ziye; after Fang Ziye agreed, Lu Chaoyang and Liu Faming immediately began discussing the patient's current condition.

The provisional diagnosis: open abdominal injury with active vascular injury. The patient already had massive hemorrhage on admission; the exact blood loss is unknown, conservatively estimated at no less than 2000ml, exceeding thirty percent of total blood volume.

The patient is currently in the Emergency Department receiving venous access, rapid infusion, temporary simple packing and hemostasis, pressure packing hemostasis, and other measures; he could be sent to the OR for emergency exploratory hemostasis surgery at any moment.

"Earlier Brother Qi said you had already started a case, so I called you directly." Lu Chaoyang said to Liu Faming.

"Thanks for the trouble, Brother Zhaoyang." Liu Faming lowered his head slightly, feeling a few degrees of guilt.

"Hey, you get used to it. In our Vascular Surgery, who hasn't spent ten or eight years on the road of emergency consultations..." Lu Chaoyang was about to share experience when his voice was interrupted by a phone ring.

Upon answering, Lu Chaoyang's expression instantly turned grave, and he replied rapidly: "Prepare for surgery! ~"

At Lu Chaoyang's single command, he and Liu Faming instantly straightened up; simultaneously, the circulating nurse and anesthesiologist who had already prepared the corresponding Vascular Surgery instrument packs inside the OR immediately left the operating room and went to the OR doorway to receive the patient...

This was Fang Ziye's first time experiencing such a scene; he found it somewhat novel and tense. Of course, after a few seconds of inner panic, he still very calmly went to ask Lu Chaoyang what he could do.

Seeing this Trauma Surgery doctor he had brought into the OR, Lu Chaoyang figured Fang Ziye probably didn't even know much about Vascular Surgery's routine preoperative preparations.

So he said: "Doctor Fang, you go scrub in, gown and glove, and get on the table first. Later help with draping."

Lu Chaoyang made no special arrangements for Fang Ziye, nor did he dare to give Fang Ziye the most basic Vascular Surgery teaching right there on the spot.

Fang Ziye complied upon hearing this.

Soon, the patient with an open lower abdominal injury packed full of gauze was pushed into the OR. Mi Qi of Vascular Surgery personally escorted him all the way; at this moment he still hadn't taken off his white coat.

In fact, him entering the OR in his white coat work uniform already counted as a violation.

But there was no choice — special handling for special circumstances. Right now Mi Qi was using both hands to manually compress and stop bleeding on two arteries; if either hand released any point, it might let the patient experience life and death once more.

Seeing this situation, Lu Chaoyang hurriedly asked: "Brother Qi, where's the problem?"

"Internal iliac and external iliac — specifics unknown. I originally wanted to wait for hemostats, but the patient's systolic pressure was already near 60 and couldn't wait. I could only put on gloves and reach straight in."

"Thinking: if I can save him, I'll save him!"

Mi Qi realized he had explained too much: "Blood pressure is temporarily stable. Temporarily ligate the internal and external iliac arteries, then start laparotomy exploration."

"Hemostats! ~" Only now did Lu Chaoyang give an order in Fang Ziye's direction.

But Fang Ziye, who had already scrubbed and donned his sterile surgical gown, had already maneuvered from a rather tricky angle, bypassed Mi Qi who was contaminated all over, inserted a larger vascular clamp through the open wound, and snapped it shut with a click.

Fang Ziye's voice followed: "Teacher Mi, feel it — it should be the more proximal segment of the internal iliac artery. Loosen a tiny bit and see if the vessel expands. If it doesn't expand, then go feel for the exact location."

As Fang Ziye spoke, Mi Qi raised his head and bumped against Fang Ziye's chest. Fang Ziye's brow instantly furrowed tightly at this, somewhat disgusted.

But with a life hanging in the balance right now, saving the life comes first — what does a contaminated gown matter?

"Good! ~" After Mi Qi's right hand moved a bit, a sharp glint flashed in his eyes. Only then did he release his claw, withdraw from the abdomen, and pinch twice in the air.

The sterile gloves perfectly set off his slender fingers; only in the finger crevices were dried blood scabs and not-yet-dried blood clots, looking extremely bloody.

After relaxing with two fist clenches, Mi Qi said: "Doctor Fang, give me another hemostat. I'll handle the rest. Trouble you to scrub and regown — I probably brushed against you just now."

Mi Qi also knew he had raised his head and bumped into Fang Ziye who was wearing a sterile surgical gown. But a bump is a bump. Mi Qi wouldn't panic, and wouldn't apologize.

Fang Ziye complied, handed over a hemostat, then went out again to scrub and disinfect.

Liu Faming was at the tail end of scrubbing. Seeing Fang Ziye standing at the side, he hurriedly asked: "Doctor Fang, how's the situation inside?"

"Should be alright. Oh, Teacher Mi has already come out." Fang Ziye saw Mi Qi in his white coat, already freed from the patient's body and coming out of the OR.

"Doctor Fang, your operation — pure, proficient, and practical, hitting the mark of utility." Mi Qi greeted Fang Ziye while quickly bypassing the two at the scrub sink and heading off into the distance.

A white coat isn't suitable for staying long in the OR; in emergencies it's a stopgap measure — an unavoidable thing. But after delivering the patient, leave he must.

"Teacher Mi, are you saying my operation lacked technique?" Fang Ziye interpreted it from another angle.

"Practical is good. At a time like this, what's the use of fancy posturing." Mi Qi said, already nearing the OR doorway. He changed shoes and went out the door.

This distance was no longer suitable for chatting.

Only then did Fang Ziye and Liu Faming scrub, gown, and complete disinfection and draping. After that, the three of them, together with another Vascular Surgery Doctor, formed the lead surgeon and first, second, and third assistants, and began the abdominal debridement and exploration.

The first stop was the left internal and external iliac arteries. Looking at the hemostats placed temporarily earlier, they had already effectively stopped the active massive spurting; only a few minor bleeding points remained.

In Lu Chaoyang's view, this wasn't much of a problem. While casually electrocoagulating a few small bleeding points with the electrocautery, he said: "This lower abdominal open injury — the damaged vessels are fairly typical."

"It's a common vascular combo injury entering through the left middle-lower abdomen. This combo — many patients have been sent in with it. So when Brother Mi Qi saw this situation, his first reaction to clamp the internal and external iliac arteries was very appropriate..."

As Lu Chaoyang spoke, he click-click used hemostats to clamp a few arterial branches downstream of the internal and external iliacs in an orderly manner.

"Brother Zhaoyang, this is the 'divide and ligate' technique, right? Under the condition that one branch is confirmed not bleeding, restoring its blood supply can reduce the blood flow through the bleeding branches." That Doctor asked.

"Right, that's it..." Lu Chaoyang glanced at Fang Ziye while speaking, and discovered Fang Ziye was in a state of listening attentively, as if he knew nothing of these basics.

However, Lu Chaoyang wanted to test Fang Ziye's operative skill, so he deliberately left an intentional operational gap for Fang Ziye — which Fang Ziye swiftly caught and handled.

This reaction speed, this operative accuracy.

Without a doubt, this is the basic skill that many young Vascular Surgery doctors greatly long for — a hemostasis technique at the mastered level.

It's just that his sissy skills grew crooked — they didn't grow on Liu Faming and the others, but instead ran off to Fang Ziye; this is purely wasteful destruction.

"How is Doctor Fang's suturing technique?" Lu Chaoyang asked on a sudden whim.

Upon hearing this, Fang Ziye knew he might have an opportunity, so he analyzed it in terms of operation difficulty that Lu Chaoyang could better understand: "My blood vessel patency rate for nude mouse tail artery anastomosis should be able to surpass ninety percent."

Vascular anastomosis is one of the absolute basic skills that is a hallmark of hand surgery.

Lu Chaoyang's hand indeed trembled slightly.

Next door, Liu Faming, who was just about to perform vascular anastomosis, and another Doctor, upon hearing this, silently 'threw' down their needle holders, looking at Fang Ziye while swallowing saliva and narrowing their eyes.

The glance cast at Lu Chaoyang was full of reproach.

Brother Zhaoyang, don't ask — if you don't ask, we'll accept this operation opportunity. Now it's good, you've already asked, so Fang Ziye has to be given priority to suture at least a segment first, and then let go to give us permission!

What kind of trauma surgeon is this?

Everyone's internal activity was quite turbulent.

(Chapter End)