This doctor is already middle-aged, and he's only just started practicing medicine.

Chapter 162 Limb Replantation!
"October 1st, Thursday, Clinic day shift: Zhang Tiesheng, Clinic night shift: Tian Zhuang; Ward day shift: Du Daihua, Ward night shift: Han Xiaoping, Surgery shift: Lu Cheng."

"October 2nd, Friday, Clinic day shift: Zeng Huanqi, Clinic night shift: Zhang Tiesheng; Ward day shift: Tian Zhuang, Ward night shift: Du Daihua, Surgical shift: Han Xiaoping."

"..."

After Lu Cheng carefully reviewed the duty roster sent in the department group, he marked his own duty shift on the calendar.

After that, Lu Cheng put all his skill points into the Stitching Technique, went into the training room, caught a poor but cute little hamster, and paralyzed it...

About an hour later, Lu Cheng finished suturing the three severed and four segments of the coccyx and sat on the stool in the training room, lost in thought.

【缝合术（专家15/200）（技能点-15），血管缝合术（熟练8/10）（+2）、神经缝合术（熟练8/10）（+1）、断肢再植术（熟练10/10）（技能点-4）】

Current skill point balance: 16.5 points

After glancing at the skill point earnings details on the panel again, Lu Cheng saved them to a table in his notebook and filled in the following paragraph.

A: 0.3; B: 0.2; C: 4.8.

This wasn't Lu Cheng using sign language; rather, he was recording his skill point gains details.

A represents teaching income, averaging 0.3 per day; B represents income from lingering over doctor's orders in the ward, averaging 0.2 per day; and C represents Lu Cheng's own average daily surgical income.

It is clear that the current benefits of mentoring outweigh the procrastination and delays in receiving medical advice in the ward.

The daily skill point gain is 5.3. According to Professors Chen Song and Tong Yuan'an, many experts at Xiangya No. 2 Hospital can gain about 1 proficiency point after 20 hours of practice...

Even if some geniuses can gain 1 point of proficiency in ten hours or even five hours, they can still create a speed difference with them.

Lu Cheng's phone flashed briefly. He picked it up and glanced at it; the message was from Mu Nanshu.

Mu Nanshu said they had already set off for Jilin City and had just arrived at the highway tollbooth entrance. Mu Nanshu took a picture and sent it to Lu Cheng.

"Have a safe trip!" Lu Cheng had already sent his schedule to Mu Nanshu.

The miserable life of a clinician is that holidays are irrelevant to doctors; they still have to be on duty when needed.

"We will be going to Xinjiang Province for tourism on the 2nd."

"I'll see if I can come back during the last two days of the National Day holiday."

Mu Nanshu said.

Lu Cheng replied with a smile, "Have fun!~"

During the seven-day National Day holiday, Lu Cheng was on duty, his father still had to go out to drive his truck, his mother had to set up a vegetable stall, and Mu Nanshu's whole family went on a trip.

This is how different families live their own lives; it's something you can't envy.

After chatting with Mu Nanshu for a while, Lu Cheng received a call from Han Xiaoping, who was on the day shift in the ward.

“Brother Han…” Lu Cheng answered immediately.

"Brother Lu, a patient with a severed limb came to the outpatient clinic. The orthopedic specialist's opinion is to transfer the patient to another hospital or to embed the stump."

“The patient has been injured for some time. He was transferred from Miaoshi Town. It might not be enough time to transfer him to the State People’s Hospital at this point.”

"What do you think?" Han Xiaoping immediately asked Lu Cheng for his opinion.

Longxian County does have cases of amputated limbs and fingers, and it's not like there weren't any cases where patients couldn't be transferred in time. However, the previous approach was to perform a "quasi-amputation" procedure to bury the stumps.

If a referral is not possible, the illness still needs treatment.

There is a golden time for limb replantation treatment; beyond this time, referral is meaningless.

"Let me come and see what's going on."

"Brother Han, could you send me the plane of the fracture end?" Lu Cheng said.

"What is the patient's own opinion?" Lu Cheng asked.

The treatment methods differ depending on the plane of the fracture end.

Complete limb amputation requires internal fixation of the fracture, which is something Lu Cheng currently lacks practical experience in handling.

However, Lu Cheng can also make up for his shortcomings by adding points.

“Of course the patient and their family are anxious, and they are currently struggling with this decision,” Han Xiaoping said.

"Then let's explain it to the patients. If they are willing to be transferred, we will treat the stump and stop the bleeding immediately before transferring them. If they are willing to stay, we will let them choose between stump burial or trying limb replantation."

"He might not survive, but there's still hope!"

"By the way, Brother Han, which doctor is on duty in orthopedics today?"

Han Xiaoping glanced outside, lowered his voice, and said in a evasive tone, "It's Director Xiang on duty."

"Okay, sure." Lu Cheng nodded.

……

Lu Cheng rode his electric scooter to the entrance of the emergency department and stopped. He immediately jumped off and walked quickly toward the emergency department while checking the pictures sent by Han Xiaoping on his phone.

The patient was a carpentry apprentice who had his left forearm severed by a saw. He was not very old, only a teenager.

After putting away his phone, Lu Cheng immediately rushed into the emergency room.

Both Director Lin Qianlong and Xiang Kuihua were communicating with the patient's family. At this moment, Lin Qianlong said, "It's impossible for our hospital to guarantee that the patient can be saved."

"No one can guarantee where you will go."

"Either you choose to be referred, or you can listen to the advice of Director Xiang from the orthopedics department and have the stump buried."

The patient's family member, presumably her mother, was crying her eyes out: "Doctor, my son is so young! What will we do if he loses his hand?"

"There's nothing we can do. Our hospital only has this much technology. We can do it, but the chances of survival are slim, less than 50%."

"You've wasted so much time, now you probably only have less than a 30% chance of survival."

“If you are transferred to Jilin City, and it takes another two hours, there is basically no chance of survival.”

"That's the truth, it's not just a regular fracture."

"You saw it yourself..."

"The director's opinion is to bury the stump, which will guarantee 100% success, and one surgery can solve the whole problem."

The boy wasn't very old, probably around sixteen or seventeen. At this moment, his face was pale, and his eyes were bloodshot and lifeless. He just wasn't crying.

"Thirty percent? That's way too low!" The middle-aged woman's expression was one of despair.

Lin Qianlong nodded: "It is a bit low, that's a fact. You expect us to guarantee a good result? That's impossible!"

"I can tell you absolutely right now that there's no guarantee it will work out, and the chances of it not working out are even greater!"

"Hurry up and choose, either referral or stump embalming, don't waste any more time," Lin Qianlong urged.

"If you delay any longer, the chances of success are less than 30%." The woman's phone rang at that moment. She answered it hurriedly and relayed Lin Qianlong's words.

A hurried, hoarse middle-aged man's voice came from the other end: "Why is it so low?"

"The doctors here said they can't do it," the woman replied.

"It's only because the island is relatively young that they're willing to gamble. The chances of failure are extremely high, and the county basically can't perform this kind of surgery."

"Then let's do it, what else can we do?"

"I shouldn't have let Kojima learn carpentry. Let's do it."

"Xiaodao, Dad is sorry."

The young man named Kojima panicked, his voice hoarse and cracking: "Dad, am I going to be crippled...?"

The patient must have been to the town's health center, so the severed hand was preserved relatively well, sealed with ice packs.

After Lu Cheng approached, the woman nodded: "His father said he's going to have surgery, Director. But the money can only be paid later."

"I came in a hurry and didn't bring my card."

Lin Qianlong said, "This isn't about money right now. Let's get into the operating room immediately."

"Zhang Tiesheng, you'll be in charge of signing this, and then you can take the documents into the operating room later."

"Director Xiang, would you like to help with the signing of the statement?" Lin Qianlong asked Xiang Kuihua.

Actually, the best person to talk to is Lu Cheng, but if Lu Cheng doesn't go into the operating room, the surgery can be skipped.

Xiang Kuihua didn't hesitate: "Okay, Director Lin, you go ahead, I'll come back later."

"Come with me. Your son's condition is extremely urgent. I won't waste any more time or words with you. He needs to have surgery immediately."

“The risks are so few, and we’ve explained them all to you…” Xiang Kuihua and Zhang Tiesheng went to the doctor’s office in the emergency department together.

Lu Cheng and Lin Qianlong personally took the patient to the emergency operating room.

After Lu Cheng took over the patient's case, Lin Qianlong immediately made several phone calls, starting with the on-call supervisor, to tell him about the unpaid surgery fees.

Next, I called the anesthesiology department...

After Lu Cheng and Lin Qianlong arrived at the operating room, Hou Jiagui, the director of the anesthesiology department, had already arrived in person.

The head nurse of the emergency operating room, along with two other nurses, were already present.

This was the first time a limb replantation had been performed by a single surgeon in the hospital, and Lin Qianlong and no one in the operating room dared to be careless.

The patient was anesthetized very well, and a rapid general anesthesia was chosen.

We're already trying to save time, so we won't waste any more time on nerve block anesthesia.

Lu Cheng and Lin Qianlong quickly completed the disinfection and towel-laying process.

Zeng Huanqi was also called to the operating room!
After dressing and putting on gloves, Lu Cheng said, "Director Lin, the timing of this patient's injury is quite special, so we need to reverse the standard surgical procedure, first perform arterial and venous anastomosis, and then perform internal fixation of the fracture."

After Lu Cheng finished speaking, he quickly said to the circulating nurse and the scrub nurse, "Prepare more heparin and saline solution."

"Make a few more syringes with needles."

"It would be best to have a cardiologist on standby. For this amputee patient, we also need to be careful about reperfusion injury, as electrolyte imbalances may occur during the surgery," Lu Cheng told Hou Jiagui from the anesthesiology department.

“Okay, no problem. As long as your surgical team can handle it, this small reperfusion can be done.” Hou Jiagui said confidently.

Previously, orthopedic surgeon Tong Yuan'an had performed many cases of limb and finger amputations, and he had gained considerable experience in handling such cases.

"First, clean the wound!" Lu Cheng picked up the scalpel and officially announced the start of the surgery.

The circulating nurse replied, "Time: 11:23:47 AM. Surgery begins. Limb replantation."

No matter how long it takes, the wound must be thoroughly cleaned before suturing the blood vessels. Otherwise, if the wound is cleaned after suturing, the sutured blood vessels will be torn, causing secondary damage.

The serrated cut would cause local blood vessels and nerves to rot away, so the necrotic tissue needed to be removed. Of course, all of this was within Lu Cheng's expectations...

Longxian County, Tianyue Residential Area.

Peng Haibo received a call from someone in the operating room: "Director Peng, the emergency department is performing a limb replantation procedure. It's being led by Director Lin from the emergency department."

Peng Haibo was watching TV when he heard this and his expression froze.

After a few seconds of silence, he said, "Director Lin has the ability; he can handle it himself."

"But isn't limb replantation a procedure performed in your orthopedics department?" The nurse on duty in the operating room asked, slightly puzzled.

"Professor Tong has already gone back. Is it in accordance with regulations to perform this kind of surgery now?"

Peng Haibo's response was rather official: "Whether it's in accordance with regulations or not, Director Lin of the Emergency Department has his own reasons. Anyway, our orthopedics department can't perform this kind of surgery."

"Okay, Director Peng, I just wanted to give you a brief report." The nurse on duty hung up the phone.

All she knew was that the head nurse had personally gone to the emergency department operating room, but since she was the nurse on duty today, she might also be held responsible if something went wrong during the surgery, which is why she asked this question.

Peng Kun was also at home, and although he had been watching TV, he had lost all interest in it.

Peng Kun glanced at Peng Haibo: "Lu Cheng? Really?"

Peng Haibo sighed and put his legs down: "Don't think too much about it. Lu Cheng has made it clear that he won't stay in our hospital for long."

"What you need to think about now is how to make a breakthrough in the field of hand surgery, which is a blank area in orthopedics, and how to master the techniques thoroughly."

Peng Haibo then glanced at Peng Kun: "Don't take what Xiang Kuihua and the others say to you seriously. These people are shrewd and won't confide in you."

Peng Kun felt this deeply: "They didn't take you seriously at all."

Peng Haibo sighed softly: "What's the point of whether we take it seriously or not?"

"This is it for me in this life; I can't learn anything more now!"

"At least for now, I know more than them. As long as I don't make mistakes, they can only keep their ideas to themselves, no matter what they want."

"But this situation won't last long."

"I estimate that when the next director is re-elected... never mind, let's not talk about this anymore," Peng Haibo said helplessly.

He really didn't expect that after Lu Cheng and Xiang Kuihua had a fierce battle, the fire would end up burning him instead.

Xiang Kuihua's trip outside for training resulted in such a significant improvement. Consequently, Executive Director Luo and others also began to seek opportunities elsewhere, leading to another major shift in the department's situation.

After hearing these words, Peng Kun stood up: "I'll go practice for a while longer..."

Ultimately, it all comes down to our own inadequacy. If Peng Haibo were stronger, or if Peng Kun had the same abilities as Lu Cheng, the situation in the department would be very different now.

Although Peng Kun's backer is only Peng Haibo, as long as he has enough ability, even Xiang Kuihua and his associates can't bring Peng Kun down.

The food itself is the real problem!!
(End of this chapter)