Path of Medicine With a System

Zhang Fan and Chen Qifa really couldn’t help but inhale cold breaths when they saw the young boy’s injured fingers. The skin on his right hand’s thumb and index finger’s fingertips seemed just like a black blooming chrysanthemum, with the fingers being completely open. To describe more directly, all of the skin on the fingertips had been shattered by the explosion, exposing injured red muscles beneath. After clearing away the cotton covering the fingers, the fingers began to bleed again!

As Zhang Fan checked the injury, the boy cried extremely loudly in pain. The boy’s father tightly hugged his son while holding the boy’s other hand. Tears streamed down the boy’s mom’s cheeks as she helped to hold the boy’s injured hand and prevent him from moving too much.

“Did your son set off a firecracker or a blasting cap?! Why is this injury so severe?” Zhang Fan asked.

“We were busy making dinner. We weren’t paying attention, and our son grabbed a firecracker and lit it.” The boy’s mother wasn’t capable of coherent speech at the moment, so the father explained as his eyes reddened. Although Zhang Fan was as gentle as he possibly could, the fingers would always have one of the densest concentrations of pain nerve sensors in the body. Mothers would always feel connected to their children. With the young boy crying in such extreme pain, of course she would also feel extremely terrible.

If this had been an adult in the same situation, the injury wouldn’t have been as severe. Young children would have thinner skin than adults. The boy had caused the firecracker to explode as he was holding it in his hand. This had actually been a relatively weak firecracker. A more powerful firecracker would have been capable of completely destroying his fingers!

In microsurgery, this type of injury had its own categorization, known as destructive injuries! Slice injuries with clean slices weren’t that difficult to perform limb replantation on. For instance, one was the surgery that Li Liang and Song Bing were working on. Although it seemed really scary that the middle-aged woman had accidentally cut off three of her own fingers, as long as she received treatment fast enough, the chance of successfully reattaching her fingers and regaining functionality would be very high. Normally, approximately 80% functionality could be restored to the cut off fingers.

However, this boy’s injury was far more severe than the middle-aged woman’s. Even though only his fingertips had been injured, his skin had already been destroyed, and his muscles had also been injured deeply and severely. Even white bone was already visible. Not only that, this was his right hand’s thumb and index finger. Without any skin, it would be impossible to preserve these two fingertips.

It was easily imaginable just how hard life would be without a fully functional thumb and index finger. Not having a thumb would even allow this boy to directly obtain a disability card in the future. Yet, this boy was still only six years old. The rest of his life would be much darker if his fingertips couldn’t be preserved!

Although the child was crying in extreme pain as Zhang Fan checked his fingers, the child’s parents and the grandparents waiting outside didn’t try to stop Zhang Fan at all. Crying and pain were nothing to them as long as the child’s fingers could be preserved!

Zhang Fan examined the child’s fingers. He was already drawing a plan to preserve these fingers in his mind. Although the child’s injury was very severe, it was still treatable due to the assistance Zhang Fan received from his System.

“Doctor, I’m begging you! The Chinese medicine hospital that I went to told me that only this hospital is capable of saving my son’s fingers. I’m begging you! You must save his fingers!” When the mother saw that Zhang Fan was remaining silent for quite a while, she mentally broke down. The tears that she had been suppressing were suddenly all unleashed as if a dam had broken, pouring out like a flood.

“Awoo! Awoo!” Her crying sounded like that of a mother shewolf in despair. Her trembling hands were covered in lots of blood from her son! Although the child’s father didn’t cry out loud, tears were also trickling down his reddened eyes, falling onto his son in his embrace.

Chen Qifa wanted to say something, but he had no guarantee of being able to successfully perform this surgery at all. He opened his mouth, but was unable to say anything in the end, so he looked at Zhang Fan.

“It’s possible to save his fingers!” Zhang Fan declared. He then told Chen Qifa, “Prepare for surgery.”

When Zhang Fan said that it was possible to save his fingers, the boy’s mother felt as if she was hearing an angel’s voice. All of the tension left her body as she sat down on the ground, her body going soft all over. When she had visited the Chinese medicine hospital, the doctors there had told her that they would have to amputate the boy’s fingers if they were to treat him. She felt as if her entire world had turned gray then, feeling only despair and helplessness!

Luckily, Zhang Fan’s hospital had done plenty of advertising with other hospitals ever since Ma Wentao started the practice. Sales managers from the hospital had gone countless times to every possible city hospital, Chinese medicine hospital, and other hospitals in the area. If the Chinese medicine hospital hadn’t given this family a referral to Zhang Fan’s hospital, then not only would this family’s current Spring Festival have been ruined, it was likely that they would never celebrate the Spring Festival again, as it would be nothing more than a terrible memory!

The boy’s injury no longer counted as a normal injury, as it would be classified as multiple trauma. The powerful explosion from the firecracker hadn’t only shattered the skin and injured the muscle. The explosion had also caused burn injury and necrosis to the nearby skin. That was how horrible and severe this injury was.

Chen Qifa suddenly became reinvigorated when Zhang Fan said “It’s possible to save his fingers!” and to “Prepare for surgery.” Chen Qifa immediately began giving orders quite swiftly. “Why cry? Now’s not the time to cry! Hurry and come sign the surgery agreement and pay the surgery fee so that we can prepare the surgery. Someone, push the C-arm X-ray to operating room #2! Hurry!” He acted as if he was the head nurse, busying himself.

The parents now felt as if a dark cloud had been removed from over them. They looked at Zhang Fan with expressions filled with gratitude. Zhang Fan exited the examination room and prepared to go into the operating room. The grandparents waiting outside didn’t dare to bother Zhang Fan, but their teary eyes were filled with expectations, their frozen lips were trembling, and they had pitiful expressions. They seemed so old with their white hair!

Zhang Fan turned around after he passed the grandparents, and suddenly said, “Please rest assured, it will be alright!”

Everyone would have empathy. It was just that as time went on and people grew older, some people’s empathy would fade as the heart hardened!

Inside the operating room, the head nurse was gently consoling the young boy! This was an advantage that women had. If Zhang Fan tried to console this child instead, it was likely that the boy would just cry even more. Why was this? Maybe it was because Zhang Fan had dark skin!

The child didn’t dare to cry too loudly, maybe because he was now separated from his parents and was afraid. Still, he curled himself up into a ball, and his limbs were trembling in fear. He seemed just like an injured fawn facing a horde of hungry lions!

“So pitiful!” Chen Qifa glanced at the boy. Perhaps Chen Qifa was thinking of his own son when he said this.

Zhang Fan glanced at the child, but didn’t say anything. The anesthesia then began. If the skin hadn’t been damaged, then the surgery could have began with just local anesthesia followed by cleaning the injury. It would have been an incredibly simple surgery. However, since the skin was damaged, this alone would elevate the surgery’s difficulty by several levels.

After anesthesia was finished, Zhang Fan began to clean the injury. The child’s injury was basically the equivalent of a firearm injury as far as cleaning was concerned.

Zhang Fan used a large amount of isotonic saline solution to rinse the wound. He had to first wash away the broken tiny fragments of flesh in the injury. He then used his scalpel to gently remove the remaining gunpowder particles all around the injury.

“Tourniquet!” Zhang Fan didn’t apply a tourniquet until he was done cleaning the injury. This was because he needed to know which places were still bleeding and which places already had dead tissue.

For this surgery, Chen Qifa acted as Zhang Fan’s surgical assistant. The surgery proceeded in an orderly manner. The surgery would only affect a very small portion of the body. However, the fingertips were far too important despite their small size. It wouldn’t have been this troublesome even if the child had exploded the firecracker on the palm instead. At most, that would just require a skin graft. However, most normal skin grafting wouldn’t work for the fingertips. Blood supply would always be poorer at the end of any limb. After the explosion, the blood circulation system here would be destroyed. The skin wouldn’t live even after a skin graft.

The most important prerequisite for this surgery was to clean the injury. It was absolutely critical for the cleaning to be as thorough as possible. After that would be eliminating all of the dead tissue. Any dead tissue that wasn’t eliminated cleanly would become trouble down the road as a source of infection. Basically, it would be the equivalent of leaving dead and rotten flesh buried in your body.

Dealing with all this was only the first step. The following was the most important part of all. How was this surgery supposed to be performed? With no blood vessels and no skin left due to the explosion, no ordinary surgery would be able to deal with this situation.

Since the patient was a young child, Zhang Fan chose to use a cross-arm skin flap surgery. What exactly did this mean? A surgical flap would be chosen from the child’s contralateral upper arm or forearm. What exactly was the surgical flap? That would be a portion of the skin with blood supply, including the fat, tissue, and circulation system underneath.

To explain more simply, the surgeon would find a corresponding location on the arm, and cut open a portion of the skin there where the muscle was thicker. This entire section of skin, including muscle and blood vessels, would be used to repair the completely destroyed portion in the hand.

This surgical flap portion would need to be sewed together with the child’s fingertip. Literally, the child’s fingers would be sewed into the arm. This was because the surgical flap portion had yet to be detached from its original location. Sewing the child’s fingers into the surgical flap would allow this location’s blood vessels to provide blood supply to the fingertips. The doctor would then wait for the transplanted location to regrow blood vessels before separating the two locations again.

After this surgery was complete, the child would look like his fingers were literally connected to his arm, with two fingers inside the arm.

Since the patient was a young child, Zhang Fan made sure to be extremely thorough with his work. A young child would continuously be growing. If the surgery wasn’t done well, or the surgical flap’s location wasn’t chosen well, that would directly affect the child’s future growth and functionality.

Surgical flap designs required great precision in choosing the location. Doctors who had rougher techniques still might be able to preserve the fingers with a cross-arm skin flap surgery, but the regrown finger skin would be incredibly ugly if the surgical flap location wasn’t chosen well. It would look as if wads of meat were growing on the fingers if the surgical flap was chosen poorly.

Why was it that some doctors would be unable to choose the surgical flap location with precision? That was because this type of surgery was relatively rare, which meant doctors would lack experience. It wasn’t because the doctor wasn’t careful enough. But for Zhang Fan, choosing the proper surgical flap location wasn’t difficult at all, due to how much he had already practiced this in his System before.

He slowly opened up the deep fascia in the child’s contralateral upper arm, stopped the bleeding, and then gently combined the child’s injury with the surgical flap. This surgery was truly just like sewing a tiny flower. The injured location was far too small. Zhang Fan had his head lowered, so his head covered the entire injury and nobody else was even able to see what he was doing. Chen Qifa had his back bent over while draining blood and wiping the injury.

The surgical flap’s tissue was connected to the injured location’s tissue. This would act as a channel to protect the child’s injury, allowing it to revive. After finishing the connections, Zhang Fan swiftly sewed everything back together, directly burying the two injured fingers into the left upper arm.

Before wrapping everything up, it looked as if the child was making an “OK” emoji sign with his right hand. However, his index finger and thumb were now surgically embedded into his left arm’s flesh.

Although this was a difficult surgery, Zhang Fan’s speed was still far faster than Li Liang and Song Bing working on the other far simpler finger reattachment surgery. As Zhang Fan and Chen Qifa began the pressure dressing, Li Liang and Song Bing were still working on reattaching the third of the woman’s three cut off fingers!

Zhang Fan gently inserted cotton between the injured hand and the left arm. He then affixed everything using rubberized fabric. He tied things up for the child in a beautiful triangular sling, letting the right arm dangle.

This surgery wasn’t finished yet. After two to three weeks, the injured location would revive. That would be the time to separate the fingers from the arm. Although this was a long period of time, and would be relatively uncomfortable as well, this was still better than having the child’s family finish the Spring Festival with no hope at all!

Zhang Fan stretched his back at the end of the surgery. It had taken a bit more than two hours. “After this, you absolutely must tell the parents to properly watch over their child. The child is still young and doesn’t understand many things yet. If he accidentally pulls too hard, he might break the attachment. That will ruin everything. The doctor placed in charge of monitoring this child will also need to pay close attention to the attachment’s stability.”

“Alright. I’ll personally manage this child as my patient. Teacher Zhang, you should return home as early as you can. It’s almost 11 at night already.”

“There’s no rush. Let’s wait for Li Liang and Song Bing to finish their surgery. We can all eat a Spring Festival dinner together afterwards. Do you have anything prepared?”

“Yes. I already prepared many frozen dumplings here for the doctors and nurses. We can have a little party for ourselves afterwards!”

Outside the operating rooms, the boy’s family and the middle-aged woman’s family were quietly waiting. Both families felt similarly anxious and worried. The sounds of firecrackers in the distance seemed so annoying and ear-piercing to them right now!

Meanwhile, at Chen Qifa’s home, his wife and son were looking outside the window. It was already completely dark outside. “Let’s just eat! Your father is probably performing another surgery! Sigh, he never gets any time to rest.”

At Shao Hua’s home, Jingshu was bored while watching a Spring Festival show on TV. Shao Hua’s father was repeatedly looking out the window at the neighborhood.

“Let’s just eat! I don’t think he will be able to come. We should eat without waiting for him. Here, Jingshu, let me pour a drink for you.” Shao Hua forced herself to smile.

Why didn’t they call Zhang Fan? The answer was quite simple. If the doctor was performing a surgery, their family members typically wouldn’t call unless there was something major! Only the doctor called home first.

Everyone else was celebrating the Spring Festival in China, but doctors and similar specialists were still performing their jobs as normal.

Spring was coming!