Chapter 742: line with translation of title

Lu Zewei gave an embarrassed smile, but as Su Yun lowered his head, his expression gradually became solemn.

Compartment syndrome, decompress by incision? The tissue is already completely necrotic, how to decompress?

Although he is not in orthopedics, Lu Zewei still understands the most basic common sense.

The surgeon again took a longitudinal incision about 20 cm long on the lateral side of the right calf, cutting through the skin and subcutaneous tissue.

He opened the fascia of the lateral and anterolateral compartments, seeing that the tension inside the fascia was relatively high and the muscle had already necrosed.

The surgeon sighed and began to remove the necrotic tissue.

"Boss, how much will the motor function be affected?" Su Yun suddenly asked.

"It's significant, but better than amputation." Zheng Ren replied, "Being able to keep a leg already counts as a relatively mild injury. After the operation, doing more functional exercises, other muscles may compensate for some function."

It's not because the entire muscle segment was removed; this surgical approach is rare, but it has definitely happened before.

He felt a bit dazed, because he heard Su Yun call the young man standing before him—Boss.

Such a young little boss? Being in orthopedics, what ability does he have to make the usually chatty and sharp-tongued Su Yun behave himself?

The surgeon and Su Yun were conversing, but his hand movements did not slow in the slightest.

He explored the operative area, seeing that the anterior tibial artery at the level of the tibia-fibula fracture was injured and narrowed, with distal pulsation markedly weakened while proximal pulsation remained normal; the superficial fibular nerve was intact in continuity, so he applied warm saline wet dressing, then explored the posterior tibial artery, and at the same level of the tibia-fibula fracture, proximal pulsation recovered.

"Finally reopened, and the embolism time was relatively short; if it had lasted a few more hours, it probably wouldn't have worked."

Zheng Ren went to find the anesthesiologist to have a look at the foot; the anesthesiologist was also excited, quickly walked around Lu Zewei, opened the saline gauze, and used his hand to feel the injured person's foot.

"The dorsalis pedis artery has a fluctuation!" the anesthesiologist said excitedly.

"That means it's completely reopened." Zheng Ren was also happy and asked, "Is VSD negative pressure suction available?"

"Postoperatively, depending on the situation, if the incision for decompression has a problem……"

"Boss, you're so talkative. This is the Provincial Hospital; the most basic operations don't need your worry." Su Yun looked up at Zheng Ren and said.

The recovery of arterial pulsation signifies many things; the simplest is that this injured person brought in can temporarily avoid amputation.

The reason it's only temporary is because there is necrotic tissue locally, plus compartment syndrome; whether the muscle, blood vessels, and nerves can survive is still uncertain.

What remains depends on subsequent treatment measures; among them, the VSD decompression technique is this one.

VSD technique, also known as vacuum-sealed drainage technique.

Negative pressure suction acts on the cell membrane, causing it to expand and distort; the cell perceives this as injury, transmits injury information to the nucleus, via signal transduction induces the cell to secrete pro-healing growth factors, including angiogenic factors, thereby stimulating the tissue to produce more new blood vessels.

Moreover, it can effectively reduce the possibility of postoperative infection.

For the injured person lying on the operating table, without VSD decompression equipment, the chance of saving his leg is less than 10%; but with VSD decompression equipment, there is an 80% chance of saving the leg.

"Hehe." Facing Su Yun's words, Zheng Ren had long been immune, merely giving a hehe laugh.

"Boss, speaking of VSD decompression, do you know any other uses?" Su Yun suddenly asked.

At this moment, all difficulties were readily solved; Zheng Ren was also happy and said, "Is it the negative pressure suction acting on ED treatment? I think it's quite unreliable. Although various literature have related reports, the amount of data is not enough, so I hold a skeptical attitude toward this."

"You even know this?" Su Yun exclaimed in surprise.

"When I studied VSD decompression, I had seen related literature reports." Zheng Ren said, "If you want to do it, there will likely be technical improvements soon, so there's no rush."

"Um……" Lu Zewei saw Su Yun suffer a setback, and secretly felt pleased.

Back then, I constantly couldn't talk back to Su Yun in front of him, not because this guy reads everything and has high technical skill, making his nitpicking extremely sharp.

Unable to talk back, because his skill is inferior to others.

Lu Zewei's secret pleasure lasted only a few seconds, but upon second thought, he was immediately stunned.

Facing Su Yun's provocation, the surgeon before him easily defused it. How could he do that? It's not because as soon as Su Yun opens his mouth, the surgeon knows what he's going to say next.

This is a crushing superiority of knowledge reserves; although not as direct as a crushing of technical skill, but from a side perspective……

"Hmm, it seems so, but Lu Zewei isn't quite sure."

He looked somewhat blankly as the surgeon again performed a dorsum decompression on the injured person; the surgeon palpated the dorsalis pedis artery and said, "The fluctuation is still good; I want to make an image to have a look."

"Boss, this isn't your style." Su Yun had just silently suffered a loss, seized on Zheng Ren's remark, and wanted to retort.

"Well, embolism is a destructive procedure; I prefer to play it safe. But for revascularization surgery, I always keep in mind wanting to see the outcome of capillary reperfusion." Zheng Ren said calmly.

Lu Zewei looked somewhat bewildered; seeing the surgeon and Su Yun begin to rescrub their hands, he still didn't understand why.

"Old Lu, come on, let's go out and have a look." The anesthesiologist pulled Lu Zewei out of the operating room.

"What... what kind of surgery is this?" Lu Zewei still hasn't figured it out.

"Old Lu, today you've seen a master." The anesthesiologist's eyes flashed with light that was somewhat blinding.

"Huh?" Lu Zewei still doesn't understand why he's so excited. Seeing the instrument nurse also come out, she sealed the airtight lead door, then quietly listened to the anesthesiologist's words.

"Old Lu, this injured person is a volunteer who went into the mountains." The anesthesiologist said: "When they were withdrawn, a stone hit his calf, causing a fracture, and it was pressed for over an hour. Because the rescue personnel arrived relatively promptly, the crush injury and necrosis are not considered severe."

"But that should still require amputation, right?" Lu Zewei was somewhat puzzled.

"This is where it's awesome." The anesthesiologist said proudly, as if the surgery were his own doing: "Just now when the injured was brought in, Director Chen had him sent up."

"The retired old chief of the Intervention Department, you haven't seen him. Old man, his temper is very stubborn." The anesthesiologist also didn't forget to comment on Director Chen's temper, then continued: "Old Director Chen said, these volunteers are here to help us; if we can avoid amputation, we avoid it. I thought it was just a wish and didn't take it seriously. But who would have thought that the surgeon who performed the surgery agreed and then began the surgery."

"I saw it, fracture fixation?"

"You saw the latter half." the anesthesiologist said, "The truly exciting part is the first half of the Shou Bing."