Discuss surgical options

The second ambulance stopped and opened the door, and paramedics jumped out of the car and dragged the stretcher down.

"There are multiple fractures, the foot is a devolving injury, and there is no abnormality in the internal organs."

"OK!"

Xiao Jing and all the doctors stepped forward and saw the little boy on the stretcher with a painful face, trembling all over and soaked in sweat.

On the exposed left foot, from the ankle bone down to the heel, the entire skin, muscle and nerve tissue are all torn.

The stretcher was stained with blood, but the dead bones could still be clearly seen.

Everyone frowned upon seeing this!

The skin of the dorsum of the foot to the ankle joint is peeled off in a large area, and the muscles and bones are exposed. This devolving injury is serious!

"Send to the emergency room, debride and stop the bleeding first, notify the image to prepare for CT, open the operating room, and prepare blood in the blood bank. Quick!"

Xiao Jing immediately said to the nurse next to her.

"Come on! Move the bed! 1, 2, 3! Walk around!"

Whoa!

Immediately afterwards, the little boy was quickly pushed into the rescue room.

"Hmm~"

Xiao Jing frowned, and as soon as she touched the little boy's calf, she heard a painful groan.

She looked at the little boy, her lips were bitten, she just didn't shout.

"I'm going to clean up your wound now. If it hurts, call it out. Don't hold back."

Xiao Jing said to him.

The little boy was still biting his mouth tightly, shaking his head vigorously without speaking, but his eyes were full of tears.

Seeing this, Xiao Jing did not continue to speak. Tramadol was injected with epidural anesthesia, and she picked up normal saline and started simple debridement.

Then he was pushed into the CT room, and the little boy Jiang carefully carried it to the instrument for a full-body scan.

Soon after the images came out, all the doctors in the emergency room began to consult.

No visceral damage has been found, mainly in the left thigh tibia fracture, calf tibia fracture and serious injury to the foot.

It can be clearly seen from the CT film that the tibia of the boy's left leg is directly broken in a staggered shape.

The calf was slightly fractured, the foot was wounded extensively, the fifth metatarsal was fractured, the left calcaneofibular ligament was completely ruptured, and the joint was unstable.

"Doctor Sun, tell me your opinion."

Xiao Jing looked at the male doctor in charge of orthopedics.

This kind of injury is in the field of orthopedics, so it is better to listen to their opinions first.

"Okay, then I'll talk about it first."

Doctor Sun from the Orthopedics Department nodded and straightened his waist.

"At present, the patient's condition is very clear. The skin of the middle and far 2/3 of the foot and the skin of the sole of the foot are completely detached and avulsed. In this case, our orthopaedic department recommends that suture be tried and no flap is needed for the time being.

As for whether it will be necrotic in the later stage, it depends on the recovery situation. If it is necrotic, I am afraid it will be amputated. "

"I don't see it that way."

As soon as he finished speaking, another doctor next to him shook his head and sighed.

"With this degree of avulsion injury, the possibility of necrosis can be said to be very high, and if the skin flap is used, the sole of the foot has no wear resistance, and it will bring long-term pain to the patient in the later stage. I don't think it is necessary."

"Then you mean, amputated?"

Xiao Jing frowned when she heard the words, and said in a deep voice, seeing the other party nod, she immediately denied it.

"No, this child is only 7 years old, what should I do now after the amputation?"

"But once the sole of the foot is necrotic, the patient not only wastes high medical expenses, but also bears the pain of a second operation. Who will bear this risk?"

...

For a while, amputation and attempts to repair, the two opinions diverged.

They are all right!

At present, the child's degloving injury situation, even if it chooses to amputate, it is understandable.

But he is so small!

The pain of amputation in future life is long-lasting, and it can even cause huge physical and mental trauma.

If you insist on retention, according to the experience of orthopaedics, the repair of this degree of avulsion injury and the later necrotic flap surgery will also be a torment for the patient.

And it is impossible to completely repair it.

The blood supply of the skin and the cutaneous nerves are severely damaged!

You must know that the skin on the sole of the foot must have a sensitive sense, in addition to the general pain, warmth, touch, but also a higher physical sense.

In addition, the subcutaneous tissue of the foot should be dense, so that it can be wear-resistant when bearing weight, walk stably and maintain balance.

Avoid the formation of ulcers in the belly of the sole of the foot and when rubbed!

After debridement of the avulsed skin, in situ suture is not easy to survive, and although the survival rate of replantation made of sliced ​​skin graft is high, it is difficult to meet the special requirements of foot repair.

In other words, the biggest difficulty of this operation lies in the suture during the operation and the survival after the operation!

But it is very difficult to succeed in both.

"How to do?"

Xiao Jing was also anxious, and now there are different opinions on the operation, and it cannot be finalized.

Bang!

"Doctor Xiao, the family is in touch."

At this moment, the head nurse pushed the door and walked in.

Family found?

Great!

Xiao Jing's eyes instantly filled with joy when she heard the words, as long as the family members came, the plan would allow them to make choices.

And the voices of everyone's arguments have also decreased, and they understand that the next choice is the family.

"How is the child's mother?"

Xiao Jing looked at the head nurse and asked.

"Compression fractures of the lumbar 2 and 3 vertebrae, comminuted fractures of the right arm, minor concussion, and no other problems have been found so far.

Surgery will be arranged in a while, and the person will probably wake up soon. "

The head nurse told about the woman's injury, and Xiao Jing was relieved.

Fortunately, the injury is not serious~

If the internal organs or the brain are injured, it is really tragic.

"Okay, everyone, let's finalize the two surgical plans, and let them choose when the family members come."

Xiao Jing took a deep breath and looked at the attending doctors.

Everyone nodded and began to prepare two sets of surgical plans.

But who should do this first in situ suture?

The orthopedic doctor couldn't help but beat a drum in his heart after some arguments.

To be honest, if he is sutured for such a decapsulation injury, the chances of survival are indeed uncertain, but as doctors, even if there is a chance of survival, they do not want a child to lose a foot at such a young age.

So he still has to try it!

"I'll call the director to come and have a look."

Xiao Jing got up and said, then walked back to the office and called Zhou Xianren.

Zhou Xianren also frowned when he saw the child's injury, and fell into contemplation.

In this situation, if he were to consider it from a doctor's point of view, the possibility of amputation would be slightly higher.

But it is not that there is no opportunity for in situ suture, but it is very demanding for doctors and later regeneration.

It even takes some luck!

"You can try in situ suture first, and finally consider flaps if necrosis occurs."

Zhou Xianren pondered for a moment and said, still denying direct amputation,

"The child is too young, no matter what, we still have to consider it from the perspective of human affection. If there is a chance, try it out."

"But who will perform the operation?"

Xiao Jing nodded when she heard the words, which was in line with his opinion, but the most serious question came.

The voice fell, and there was silence.

This is a big problem!

The two directors of the orthopaedic department are resting tonight. The two orthopaedic departments who stay on duty are preparing for the operation of the child's mother, and the other one is here.

Seeing everyone's gaze, Dr. Sun immediately shrank his neck and looked a little embarrassed.

He can do this degloving injury, but...

It's still a question of success!

"How about I call the director and ask?"

Orthopedic Doctor Sun looked at Zhou Xianren and said.

"It's so late, it's inappropriate."

Zhou Xianren shook his head and refused, filtering frantically in his mind, and suddenly stopped on the figure of a person, a flash of light flashed in his eyes,

"I know there is one person who might be able to take the lead."

"You mean Director Qin?"

Xiao Jing on the side said immediately.

"Yes, Qin Feng hasn't left yet. He is busy in the general outpatient clinic. He can have this operation, and the chance may be higher!"

Zhou Xianren nodded with a confident smile on his face.

Qin Feng?

Everyone couldn't help but tremble when they heard the name!

Yup!

This is the best surgeon in the hospital!

Especially the attending doctor of orthopedics stood up excitedly.

Director Qin, his sewing skills are amazing!

If he really came to lead the knife, he would indeed be better than himself... No~ maybe he is more confident than the two directors.

Great!

"I agree!"

Before anyone else could speak, Dr. Sun immediately said loudly.

OMG!

Director Qin is the chief surgeon, so am I the first assistant?

Participating in Qin Feng's whole process of decapsulation and suture operation on site, this treatment is expected to be the envy of all doctors.

Fortunately, he asked his senior brother to perform an operation on the mother of the child, otherwise he would lose a lot!

If the senior brother knew that he could perform the same operation as Director Qin, he would probably throw down the forceps and run over, and carry himself up to replace him on the spot.

Well now, no one can rob me!

Hahahahaha~~~

Thinking of this, Dr. Sun couldn't help rubbing his hands, full of anticipation.

The other doctors around also reacted instantly, and immediately looked at his excited expression, unable to hold back a black face.

This time, he picked it up cheap.