CHAPTER 476: DARING PLAN 476

The wound infection and avascular tissue were two major obstacles in this surgery, and they were unavoidable.

If they forcibly tried to reattach the limb now, the wound infection would worsen, risking the patient’s life. If they continued to keep the severed arm on ice while treating the infection, they simply wouldn’t have enough time.

Even the best medication requires a significant amount of time to completely clear an infection. By then, the arm would have been detached for too long.

Limb reattachment surgery has its guiding principles; it’s not as simple as just sewing the severed limb back on.

The first principle is that life takes precedence over limb reattachment.

The second is that if a severed limb has been detached for too long before reattachment, there can be potentially life-threatening complications post-surgery.

The third, and very important, principle is that survival does not equate to success. For the reattachment to be considered a success, the limb must regain a corresponding degree of practical function afterward. Otherwise, it would merely be an appendage, which would only add to the patient’s suffering.

The patient currently met two of these criteria, and the third potential issue was also foreseeable—it was almost a certainty.

"Continue with the debridement. We’ll discuss further after Doctor Wang arrives," Liu Banxia instructed after some consideration.

He wracked his brain but couldn’t find an immediate solution. His hope now rested on Wang Bo, second only to Xu Peichen in orthopedics.

Reattaching a severed arm wasn’t like reattaching a severed finger. The principles were the same, but the technical skill required differed significantly.

He only possessed a basic understanding of orthopedic surgery. It was only after assisting with a joint replacement procedure and witnessing the profound complexity of orthopedics that he felt confident enough to voice an opinion.

Wang Bo arrived quickly and, after understanding the situation, also furrowed his brow.

"Dr. Liu, this is indeed a difficult case," Wang Bo said.

"The situation is too extreme; it even involves the patient’s elbow. There’s a high probability the joint will lose mobility, and he won’t be able to grasp things. Essentially, it would only look slightly more natural than a prosthesis," he added.

"Moreover, our standard limb reattachment surgeries already carry a risk of infection. Reattaching a devitalized limb under such high risk is simply too dangerous."

Liu Banxia’s brow furrowed tighter. Despite having anticipated this, he still felt a chill.

The atmosphere in the Emergency Center had been quite gloomy recently, affecting not only him but also the others to some degree. The Emergency Center desperately needed a successful case to boost everyone’s morale.

Performing a task with passion versus merely going through the motions can lead to entirely different outcomes.

Now he had to figure out how to overcome these two obstacles and give the patient a functional arm.

Even if future mobility couldn’t be restored to its original healthy state, it needed to be maximized as much as possible.

After all, even a freshly severed limb, if reattached immediately, would still suffer some loss of function. Such an outcome is considered acceptable in surgery.

Wang Bo, in truth, had already mentally given up. His previous diagnosis essentially recommended immediate amputation and proper wound management.

For the patient, this was the safest course of action, leaving little room for hesitation.

"Teacher Wang, what do you think about temporary ectopic hosting with delayed reattachment?" Liu Banxia asked, just as Wang Bo was about to return to the orthopedics department.

"What do you mean?" Wang Bo frowned, intrigued by Liu Banxia’s proposal.

"I once encountered a case in Jinshui District where a patient’s hand was severely burned and carbonized. Our approach then was to suture the hand to an abdominal skin flap. This reduced the risk of infection and bought us a lot of time."

"Could we do something similar here? Temporarily host the severed arm on the abdomen? After all, the abdominal cavity has a rich blood supply; we could completely restore circulation to the severed limb."

"This way, we’d have enough time to treat the patient’s wound infection. Once the infection is cleared, we can then perform the limb reattachment surgery."

As Liu Banxia spoke, Wang Bo continuously mulled over the feasibility of this plan in his mind. The more he thought about it, the more he felt that, despite its boldness, it was actually quite viable.

"I must say, this adjustment could indeed buy us some time. However, we must explain this clearly to the patient. We’ve never attempted this before, and temporarily hosting it on the abdomen carries certain risks," Wang Bo said.

"Especially psychologically. It might be difficult for a normal person to accept an arm suddenly growing out of their abdomen. Even if the limb is successfully reattached later, it could leave a psychological scar."

Liu Banxia nodded. "Indeed, that’s a crucial point. Last time, that firefighter, even though it was only his hand sutured to his abdomen to promote skin growth, found it very difficult."

"However, because he was a firefighter, his mental fortitude was somewhat stronger. Plus, his comrades often visited and comforted him, which helped him adjust quite well."

"Let Li Hao handle the psychological counseling for this patient. Besides, Li Hao is the attending physician for this patient. The final decision must rest with the patient."

Wang Bo nodded. "Alright, I’ll wait here for a bit and also think about how to perform this surgery."

He agreed with Liu Banxia on this point and couldn’t help but see him in a new, more favorable light.

Irrespective of whether this surgery could ultimately be performed, just by thinking of such an unconventional solution, Liu Banxia had already taken the first step toward success.

If this surgery succeeded, they would gain invaluable experience in this area, allowing them to handle similar cases in the future.

This was also a breakthrough. Cases of temporary ectopic grafting existed, but he had never encountered one involving a major limb like an arm.

"Teacher Liu, if this arm can indeed be successfully replanted, that would be truly incredible," Su Wenhao said.

"The surgery is one aspect; the crucial aspect is the patient’s psychological resilience," Liu Banxia said.

"Once Li Hao finishes the debridement, you two go chat with him. The pressure from this incident is quite significant, so give him your full support."

Su Wenhao nodded. Even just providing support was a way to accumulate professional experience. Medical skills could be learned from attending physicians, but the art of communicating with patients and their families required gradual honing through practice.

His personality was rather straightforward, and in this aspect, he lagged somewhat behind his peers.

"Dr. Liu, what should I do?" Qing Kewa asked.

"You can just observe. If this surgery actually happens, I’ll let all of you into the operating room to watch," Liu Banxia said.

"The main thing is, you tend to be quite blunt. Many patients where you come from might accept that, but here, you need to be more mindful."

Qing Kewa nodded; she had noticed this too. So, while the six juniors were often "tormented," she, on the other hand, was having a rather joyful time.

Her status was also somewhat special, granting her relatively high "privileges." She was allowed to observe many surgeries, and Liu Banxia wasn’t too strict about her patient consultation hours.

"President Liu, the child with intestinal volvulus has completed pre-operative preparations. I’m heading into surgery now. Who wants to assist me?" Wang Chao came over after a short wait.

The last question was obviously directed at the interns. However, much to his frustration, neither Liu Yiqing nor Su Wenhao seemed particularly interested in his surgery.

"Qing Kewa, how about you go with him?" Liu Banxia asked.

"Alright. I don’t have anything else to do, and there are no patients for me to treat right now," Qing Kewa nodded.

"My goodness, what’s going on? Am I really that unpopular?" Wang Chao asked, exasperated.

"Teacher Wang, we need to counsel the patient soon. It’s about the temporary ectopic hosting of a severed arm for delayed reattachment—a matter we must take very seriously," Liu Yiqing said earnestly.

Wang Chao’s mouth fell open. "When did this happen? How come I didn’t know? You guys... forget it, I’ll go start the surgery. Qing Kewa, I’ll treat you to a chicken drumstick for dinner as a reward, but not them."

"Dr. Wang, can it be a pig trotter instead?" Qing Kewa asked seriously.

"Uh... pig trotter it is, then. I’ll make them green with envy," Wang Chao said, glancing back at them.

But what could he do? For now, he had to accept being slighted.

"Teacher Liu, the initial debridement is complete," Li Hao announced, walking out at that moment.

"The task ahead is demanding. Let these two explain it to you," Liu Banxia tossed out before heading outside.

Now that everyone else was busy—the three juniors still needing to counsel the patient—he had to take on the new patient consultations himself.

Fortunately, there were no emergency patients, just some simple minor cases, which he handled with ease.

"Teacher Liu, Teacher Liu, the patient agreed!" Liu Yiqing ran over excitedly while he was debriding a wound for another patient.

Ding! Consultation completed.

You’ve gained 200 experience points and 300 diagnostics skill proficiency points.

This reward was a pleasant surprise for Liu Banxia. Just proposing a theoretically feasible treatment plan had earned him so many diagnostic skill proficiency points, comparable to what he’d get from completing a medium-sized surgery.

"Go to my office and inform Teacher Wang. He’s probably figured out the surgical plan by now after all this time. When explaining to the patient, pay close attention and learn as much as you can," Liu Banxia said.

"Okay!" Liu Yiqing agreed enthusiastically and bounced off again.

"Doctor, are all the doctors in your hospital this lively?" the patient whose wound he was cleaning asked curiously.

"Not always. Usually, it’s when we’ve solved a difficult case or successfully helped a patient that we get this happy," Liu Banxia said with a smile.

"That’s just how our job is. Apart from payday, our greatest joy comes from helping patients. Saving an arm is like saving half a life, wouldn’t you say?"

The patient gave a thumbs-up. "That’s true. Plain words, but a solid point."

This was genuine praise from the patient. Otherwise, were they supposed to run on passion alone? Live on air and dew every day? That would be too unrealistic.