Chapter 874

·

·

·

Protagonist:

Fang Ziye

Liu Huanglong didn't leave very happily; a more accurate description would be very unhappy.

However, Liu Huanglong left, but the unfinished little crayfish remained.

Jie Han held a shrimp in one hand while asking Lan Tianluo and Fang Ziye, "Was I a bit too much just now?"

Lan Tianluo said, "What's there to be afraid of? Your current research accumulation is better than Teacher Liu's. First, you're not afraid of being targeted; second, you're not afraid of him reporting you; third, you're not afraid of him hitting anyone! ~"

"That's nothing."

Lan Tianluo added, "But Teacher Liu really knows how to eat. He can even find shrimp this delicious. I'll take a photo so I can buy some next time I want to eat them."

Fang Ziye asked pointedly, "You're not thinking of buying those shrimp to win something back, are you?"

Lan Tianluo rolled his eyes: "Simp, even dogs wouldn't be one!! ~"

It is well known that simps and dogs are not the same species. Dogs would never admit simps belong to their kind.

Just then, Lan Tianluo's phone happened to ring.

"Just hang up for me directly..." Lan Tianluo said very directly.

Fang Ziye wasn't wearing gloves at the moment, so he picked up Lan Tianluo's phone and answered: "Hello, Lin Longsheng, what's up?"

Lin Longsheng's tone on the other end was exceptionally spirited: "Is this Professor Fang?"

"Mm, Doctor Lan is eating. I just finished." Fang Ziye replied.

"Professor Fang, it's even better if you're the one who answered. I actually wanted to ask Doctor Lan to come find you."

"Professor Fang, here's the situation. A few days ago I encountered a lower limb mangled extremity patient, and the postoperative efficacy isn't very good! ~"

"This patient's situation is rather special. Professor Fang, can I send you his case records directly?"

"It would be best if you personally evaluate it." Lin Longsheng asked somewhat reservedly.

Lin Longsheng was one of the first batch of trainees in the department's "simplified" version of mangled extremity treatment training. He came for training in autumn of year 25. Although it was only for one month, he was the most gifted learner among all the trainees Fang Ziye had taught.

He is a trauma surgeon at Xian City People's Hospital, a senior attending physician. Because promotion to Deputy Director seemed hopeless, he gritted his teeth and paid out of pocket to take the course. After returning with his new skills, he was promoted to Deputy Chief Physician quite quickly and now leads his own team independently.

Because he learned quickly, he later came back to learn functional reconstruction surgery, and is preparing to come learn functional rehabilitation surgery around year 30. He counts as one of the more diligent people in prefecture-level city hospitals...

"Alright, send it over. I'll take a look at the specifics! ~" Fang Ziye said.

"Eh, okay."

"Professor Fang, actually I hope more that you'll say this case has nothing special about it, so I can continue with a second round of treatment. But based on my own understanding, this case's situation is very likely the very rare 'mangled extremity' situation Professor Fang you mentioned before." As Lin Longsheng explained in detail, he sent a Word table to Fang Ziye's phone.

Inside, the case he encountered was recorded in especially detailed and standard fashion.

The case looks very simple, and counts as relatively pure: just a left lower leg mangled extremity. The preoperative photos were a mess. During surgery, Lin Longsheng did the debridement to the extreme of what he could achieve.

Even by Fang Ziye's current understanding of mangled extremities, this patient's prognosis was quite good.

The intraoperative blood supply reconstruction was also relatively good. Lin Longsheng followed the rules very strictly, doing every surgical detail well, and recorded every detail on file. He wasn't negligent.

However, on the third postoperative day, necrosis and putrefaction appeared in the patient's soft tissue.

By the fifth postoperative day, the patient's local skin had already blackened...

After surgery, Lin Longsheng had already routinely used anticoagulant drugs. The dosage wasn't small; it was calculated according to standardization.

Moreover, there were daily photos of local blood supply assessment. The local soft tissue blood supply was relatively good, but the subcutaneous tissue blood supply seemed poor.

"Lin Longsheng, this patient's situation is indeed a bit tricky."

"By conventional understanding, if the blood supply of the outermost subcutaneous layer is relatively rich, there shouldn't be middle layer tissue necrosis."

"What about his?" Fang Ziye couldn't figure it out either.

His current situation is: the skin surface blood supply is good, but the muscle layer blood supply seems to have failed instead.

"Professor Fang, it's rather puzzling, right? Postoperatively we also did a lower limb arterial and venous ultrasound for the patient, and didn't find any abnormal pathways."

"I wondered if we forgot to do blood supply reconstruction during reconstruction. But after reviewing the surgical procedure, I found that all the blood supply reconstruction that should have been done was done."

"Yet it's still this situation, which is rather strange."

"What's relatively obvious now is that the patient's local tissue necrosis and putrefaction will soon show infection trends. I'm not even sure I can handle it."

"So I wanted to call Doctor Lan, to see if Doctor Lan could come over and do a second surgery for the patient..."

"Of course, if Professor Fang you evaluate that there's nothing special, I'll just go back in and reoperate myself." Lin Longsheng said.

"Don't. Don't go in yet."

Fang Ziye said: "Your case is very interesting. The blood vessels are clearly patent, blood supply reconstruction is clearly done, yet locally there's no blood supply reaching it."

"I've never seen this kind of situation before. Can your hospital do MRI vascular reconstruction? If so, book one for the patient first. Then get a company to 3D print its blood vessels."

"I need to take a good look. As for costs, I'll bear them myself when the time comes..."

Clinical patient volume is huge, so there is no single textbook that can summarize and generalize all specific presentations of a certain disease type's patients.

Blood vessels are clearly patent, no thrombus, but locally there's no blood supply going through, or very little blood is distributed there, leading to local soft tissue necrosis.

This looks outrageous, but there should be its own internal principle at work.

Fang Ziye's thinking was active. If this situation is real, could it be due to physical duct structure drainage issues?

If a certain physical duct structure can naturally cause blood supply to differentiate, then this would be an extremely important and major clinical research project.

Human complexity far exceeds the complexity of medical knowledge.

Since incredible situations like Mirror People exist, then some patients themselves 'evolving' structures beyond 'academic understanding' isn't inconceivable either.

It's just that such beyond-'academic-understanding' structures aren't necessarily beneficial to the patient themselves; they're actually harmful to the individual.

But if they can be analyzed, they can be transformed into effective new medical common sense or medical instruments, used to redistribute blood supply of different viscera and organs in emergency patients.

If such conditions can be met, then some traumatic emergency emergency rescues will have a longer time window.

But the specifics of how come, one still has to wait until after seeing the patient to determine.

After Fang Ziye hung up the phone, Lan Tianluo and Jie Han the two people also took off their gloves, and took the mobile phone from Fang Ziye's hand.

After looking it over, the two people instantly frowned.

Lan Tianluo instantly said with lingering fear: "Senior Brother, Lin Longsheng's this surgery, is unrelated to surgical technique and operation process, right?"

"This situation, whoever encounters it is unlucky, ah?"

Fang Ziye shook his head, saying: "Not necessarily, if it were me, I would during surgery directly correct the patient's original blood vessel pathway, would perform transposition handling on his original blood vessel route."