When the Doctor Uses A Hack

Chen Cang’s sharp, swift, and steady repositioning technique immediately caught the eye of everyone involved!

They all had experience in digit replantation surgery and had performed fracture reduction surgery on the hand, well aware of the unique nature of hand joints and bones.

However, it was precisely because they knew this that they were even more astonished. How on earth did Chen Cang manage it!

No one would ever think it was a coincidence!

At their age, they would rather believe in skill than in luck.

The seemingly casual alignment by Chen Cang just now was actually a matter of precise and subtle movements.

Huo Guoqing was first shocked, then started to observe closely.

Naturally, he didn’t think that Chen Cang was just messing around. Not even with ordinary patients would Chen Cang be careless!

There had to be a key element within.

Realizing this, Huo Guoqing noticed that Chen Cang’s hands were making continuous subtle adjustments which seemed casual but were actually laden with ingenuity; indeed, this was crucial.

Chen Cang’s eyes were fixed on the bone ends, adjusting continuously by feel, and then he applied a slight force with his fingers, operating with delicate movements without stopping.

After that, when Chen Cang felt it was good enough, he hurriedly asked Tan Zhonglin to prepare the bone pins!

Meanwhile, Huo Guoqing always felt that Chen Cang’s technique seemed familiar, this way of changing the direction of the bones through the fluctuation of the fingers, applying force on both sides…

Huo Guoqing frowned!

He was certain he had seen this technique before, but for the life of him could not recall where.

Suddenly, the screw Tan Zhonglin held was driven through, and the stainless steel wire was prepared for cross-fixation!

At this moment, Chen Cang glanced at the clock on the wall: another 40 minutes had passed!

By now, it had been 3 hours and 40 minutes since the hand was severed.

This meant that the muscle tissue cells had already begun to suffer damage due to ischemia and anoxia. If vascular anastomosis couldn’t be performed in time, it would inevitably cause some irreversible damage.

Sure, there were some case reports that claimed success even after more than 20 hours, with satisfactory limb outcomes.

But what’s the difference between that and hype or advertising.

Anecdotal cases cannot represent the large dataset.

In medicine, you really can’t rely on those individual cases to make a point.

To put it plainly, it means: Don’t count on luck!

In the face of life, no one can truly cheat fate.

Chen Cang breathed a sigh of relief; fortunately, he had not wasted too much time, which would not affect the upcoming vascular anastomosis.

Every step taken by Chen Cang was aimed at saving time while ensuring the quality of the surgery!

Just as Chen Cang picked up the “eightfold Mirror,” suddenly a voice came from the crowd.

“Doctor Chen… you seem to have not performed a bone shortening!”

This message immediately made the surrounding directors inwardly curse their bad luck.

This was not good news at all!

Huo Guoqing suddenly realized that Chen Cang indeed hadn’t performed a bone shortening!

What is bone shortening?

In the initial debridement, when cleaning the soft tissue at the severed end, those necrotic tissues are cleaned through processes like trimming, excision, etc…

This includes tissues such as nerves and blood vessels.

Therefore, after debridement, it would inevitably affect the length of soft tissues like vessels, nerves, and tendons. Since the bone might be long, coupling it afterward might make it difficult to suture and repair due to insufficient length of the nerve vascular tissues.

Hence, a removal would be needed before bone end alignment, so that the length of blood vessels, nerves, and tendons could just fit for suturing, achieving a better anastomosis effect!

But Chen Cang evidently had not performed a bone shortening, had he?

All at once, everyone couldn’t help but worry about Chen Cang.

But… in such a setting, it seemed inappropriate to point it out publicly… after all, the patient was still conscious!

Even the director who spoke felt somewhat apologetic, but… it’s a basic professional conduct for a doctor to point out issues when necessary, and he didn’t think there was anything wrong with his actions.

Chen Cang didn’t speak, but “Disciple Number Two” Tan Zhonglin said with a smile, “Doctor Chen likes to take bone abrasion into account while debriding, so he had already shortened the bone in advance.”

After finishing, Tan Zhonglin pointed to the wound and said, “Look, now the length of the vascular anastomosis is just right!”

Everyone immediately drew closer to examine carefully, and when they did, they were stunned!

Because it was indeed just right!

At this, everyone couldn’t help but exchange incredulous glances.

Debriding the soft tissue while also cleaning the bone surface, thus completing bone shortening?

This… seemed like a good idea, maybe something to try in the future!

Arteries in the arm are much thicker than in the wrist or fingers and can be sutured without wearing surgical microscopes.

But even the best eyesight cannot assess tissue damage, especially to the inner lining of blood vessels, and achieve precise vascular anastomosis the way a surgical microscope can.

At that point, Tan Zhonglin and An Yanjun immediately put down what they were doing and watched Chen Cang’s vascular suturing with great attention.

Truth be told, up until now, neither of them had fully grasped Chen Cang’s vascular suturing techniques, which always seemed simple but invariably contained hidden tricks.

Tan Zhonglin and An Yanjun watched one of Chen Cang’s surgeries every week and had recently noticed that his understanding of vascular suturing was growing deeper, almost as if guided by some ineffable principle.

Huo Guoqing, watching the suturing, hmmed, “Ah, the most commonly used intermittent suturing method. This method causes less damage to the vessel wall, reducing the likelihood of narrowing, yet it’s quite time-consuming due to its high technical demands!”

Yet Chen Cang’s subsequent suturing suddenly shifted Huo Guoqing’s understanding of this traditional method!

This… is this really the intermittent suturing method?

Are you sure it’s not the continuous one?

Doctor Chen! You… are this fast?

The chief surgeon on site was also wide-eyed and short of breath; Doctor Chen was… so fast!

Could such speed not lead to side effects?

Could it affect blood flow?

Curiosity was rife as people began to whisper and exchange their thoughts.

…

Chen Cang, completely focused, first sutured a vein and an artery, then moved on to suture another vein, and finally, another artery.

This detail led the attending chiefs to nod subtly; it was a fine idea, starting with an artery indeed could help the ischemic tissues.

It wasn’t long before Chen Cang finished suturing!

At this point, to check the suturing results, everyone gathered around for a closer look.

They saw that after anastomosis, the artery and vein were well engorged, the skin gradually began regaining its color, and the duration for capillary refill… was actually no more than two seconds!

All signs indicated that Chen Cang’s vascular suturing was very successful!

Everyone then looked up at the young man, feeling somewhat moved. He was indeed remarkable!

From the beginning until now, not even two hours had passed, and the hand was almost certainly saved, the vascular anastomosis was good, it could basically be declared a surgical success.

As of now, it was virtually guaranteed – the hand was saved!

Moreover, the time consumed from start to finish exceeded their understanding of reattachment surgery.

Each doctor asked themselves, was I this quick?

They all shook their heads in wonderment.

Indeed… prodigies have risen since ancient times!

…

…

ps: Today, I read a question from a reader asking if epidural anesthesia can be used for hand surgery. Here I can give everyone a brief overview so you can generally understand anesthesia.

Theoretically, epidural block can be used for any surgery except for the head.

From a safety standpoint, however, epidural anesthesia is mainly employed for abdominal and lower body surgeries, including urologic, gynecologic, and lower limb procedures.

For hand surgeries, if there are no systemic symptoms, there’s no need for general anesthesia, which can affect the respiratory tract and other aspects, whereas high epidural anesthesia can better control the duration of the anesthesia, suggesting this friend has some understanding of anesthesia.

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