"How long have you been injured?" Jin Cheng asked.
"Five hours! We rushed here from Qingchuan County People's Hospital." County doctor 120 replied.
Jin Cheng nodded.
Qingchuan County is relatively remote and is located in a mountainous and hilly area. It takes more than three hours to get there. In addition, emergency treatment of injuries in the local hospital also takes time.
If the scalp is avulsed, the best treatment is definitely replantation.
The best time for replanting is within 8 hours, so time is very tight.
Jin Cheng put on gloves and looked at his scalp. Fortunately, there was no further strangulation and the integrity was good. The machine should have braked in an emergency.
"Doctor, can we still be saved? The doctor from the County People's Hospital wants to send us directly to the provincial capital, and we think the city hospital should be able to do it as well." said the man's family.
Jin Cheng nodded and said: "The scalp has been torn off for 5 hours now. The blood vessels must be connected as soon as possible. If it exceeds 8 hours, it will be difficult to save it. It is too late to go to the provincial capital. Although we are a prefecture-level city hospital, , but the technical force is also very strong, and we will do our best to save her scalp! However, because the scalp is torn off, the blood vessels will also be severely torn. Even if the blood vessels are connected, the scalp may become necrotic in the future. If you are willing Take the risk and I’ll arrange the surgery urgently!”
"Yes, we are willing!" the man said quickly. He also knew that time could not wait, and he had to gamble life and death.
"Then get hospitalized quickly!"
Jin Cheng took a few photos, handed over to the county's 120 medical staff, and arranged for Zhao Xiaogang to take the patient's family members to go through the hospitalization procedures.
Zhao Xiaogang did not hesitate. This kind of case is so rare that treating one case is enough to last a lifetime.
In the past, this kind of patient would definitely have to be transferred to another hospital, because there were not many cases of scalp replantation in the province and even the country, and Changfeng People's Hospital had no experience in this treatment.
Now Jin Cheng is confident in his microsurgery skills, and with the help of Han Yue and Zhao Xiaogang, there is no reason why he can't win it.
However, such a major surgery must be reported.
Jin Cheng came to the duty room and interrupted Xu Yang's sweet dream. After informing him of his condition, Xu Yang's spirits improved.
"You go make arrangements, and I'll notify Director Tang!" Xu Yang took out his cell phone and began to report.
Jin Cheng also took out his mobile phone and started shaking people.
The first one to call was Han Yue.
Picked up after two rings.
"Han Yue, can you come to the emergency department now? There is a patient with a complete scalp avulsion and needs emergency surgery!"
"I can come, I'll be there in 5 minutes!" Han Yue answered simply.
Jin Cheng called the operating room again and informed them that a general anesthesia operation needed to be started as soon as possible and told them to prepare microscopic instruments.
In order to be able to work on the same shift as Jin Cheng, Xiao Lei deliberately arranged his shift to match that of Jin Cheng. Director Ding had no objection and even supported Xiao Lei's move. Jin Cheng knew that he was on duty tonight.
"Brother Lei, we have a general anesthesia emergency room. Get ready for intubation. The patient will be here in about 20 minutes!"
"Aren't you going to do acupuncture for general anesthesia?" Xiao Lei asked. Now whenever he has the opportunity, he wants to use acupuncture for general anesthesia. He is already familiar with the process and techniques and wants Jin Cheng to guide him once and then start it independently.
"The patient's scalp has been completely avulsed and is ready to be replanted!" Jin Cheng said concisely and to the point.
Xiao Lei was stunned for a moment, hung up the phone, and immediately started preparing for general anesthesia.
Jin Cheng then notified the radiology department and asked them to push the bedside DR machine to the operating room for preoperative chest X-ray examination.
Jin Cheng pushed the patient to the treatment room and quickly punctured the subclavian vein. After collecting blood, he handed it over to the nurse for cross-matching and preoperative biochemical examination.
Xu Yang also came over. Director Tang agreed to the operation and reported it to the medical department.
"Do you need surgical assistance?" Xu Yang tried to ask. After all, scalp replantation requires suturing several sets of blood vessels.
Jin Cheng shook his head and said: "Han Yue and Zhao Xiaogang are enough, you also have to go on stage."
Xu Yang nodded and began to notify the deputy doctor Xie Yalun to come to the department to keep watch.
After the arrangements were made, but before the preoperative examination was completed, Jin Cheng took the bag of scalps from the family members and pushed the patient to the operating room together with the family members.
When they arrived at the door of the operating room, Han Yue also arrived.
Operating room No. 8.
It used to be commonly used in the hand surgery department. After Director Tang's application, the hospital now allocates it for emergency surgeries. It has become a dedicated emergency operating room. Other departments cannot easily occupy it because the emergency department may have surgeries at any time.
Xiao Lei and Shi Jiao were ready for the operation, and all preparations for the surgery were in place.
After the patient came in, the radiologist took a chest X-ray and checked the condition of the heart and lungs. This is a necessary examination for anesthesia.
The patient was young, only in his 30s, and had been very healthy, so Xiao Lei quickly intubated the patient without any hesitation.
At the same time, Jincheng first shaved the hair clean with an electric razor, then soaked the scalp in dilute complex iodine solution, and unwrapped the gauze on the patient's head.
The head was covered in blood and flesh, from the hairline in front to the occipital tuberosity in the back, and from both sides to 4cm from the upper edge of the auricle. The entire scalp was completely torn off. The periosteum was still intact, and the skull was partially exposed!
Even Shi Jiao, who has been on the battlefield for a long time, was so frightened that she opened her mouth. The moment she was completely torn off, it must have hurt to death! It’s scary to think about it!
Xiao Lei had never seen such a scene before, so he quickly took out his mobile phone, took a few photos, and sent them to the group of anesthesiologists.
"How is the condition of the blood vessels?" Han Yue came to Jin Cheng's side, put their heads next to each other, and examined them carefully together.
The most important blood supply artery to the scalp is the bilateral superficial temporal artery.
Jin Cheng looked at it, shook his head and said: "The arteries on both sides are embolized, and the veins are probably severely avulsed and retracted!"
"Do you have a plan?" Han Yue asked.
"First anastomose the arteries, restore the blood supply as soon as possible, and then explore the veins!" Jin Cheng made a quick decision.
Everyone quickly washed their hands and sanitized their hands before going on stage.
Xiao Lei adjusted the operating room camera lens. Such a rare operation must be recorded.
"Gangzi, you and Mr. Xu will treat the superficial temporal artery in the head and remove the blood clots on both sides. Han Yue and I will treat the scalp."
After saying that, Jincheng took out the scalp from the iodine complex steel plate, placed it on the instrument table, and began to explore the arteries.
Han Yue held the scalp while Jin Cheng trimmed the tissue around the blood vessels bit by bit. The two people were touching each other head to head and hands to hands. Shi Jiao simply turned her head away, keeping her eyes out of sight.
Soon, Jin Cheng had found all the arteries. The veins were severely damaged and needed transplantation.
"Brother, you are too fast!" Zhao Xiao had just finished treating the artery on one side.
Jin Cheng and Han Yue took over to treat the blood vessels on the other side of the head.
After 3 minutes, all exploration and cleaning were completed.
Because only one microscope can be placed, both sides cannot be sutured at the same time.
Zhao Xiaogang and Xu Yang consciously gave up their positions.
Jin Cheng and Han Yue started to operate.
The diameter of the superficial temporal artery is only 1 mm. Jin Cheng chose 9-0 non-destructive nylon thread and started suturing.
