Is there no limit to this doctor's skills?

Chapter 152 What does a diabetic foot ulcer look like?

……

The operating room in the emergency room is not a dedicated operating room; it is equipped with a dressing cart and an operating cart.

You have to push the dressing cart in the emergency room control room yourself.

This medicine-changing cart might be repurposed.

As Guo Ziyuan pushed the dressing cart back, Zheng Chongyue, Tan Wenyuan, and others who had finished their shift were also walking back.

Zheng Chongyue was still explaining something to Tan Wenyuan.

However, after they both saw the dressing cart that Guo Ziyuan was pushing, they instinctively tensed up for a moment, and after a brief pause, they jogged to catch up.

"Dr. Guo, what's wrong? Have we had a patient?"

Zheng Chongyue is the attending associate chief physician on duty and, in principle, the primary person in charge of the emergency surgery department today.

Although Guo Ziyuan had good skills in reading medical images and making diagnoses, Zheng Chongyue had never seen Guo Ziyuan's emergency rescue abilities.

Although Zheng Chongyue had seen Guo Ziyuan's debridement and suturing procedures.

But can cleaning, suturing, and reviewing X-rays really contribute to a rescue effort?

Guo Ziyuan calmly replied, "No, Director Zheng, it's my previous patient who came to me to change her dressing."

"I gave her a doctor's prescription."

Upon hearing that it was just a change of medication, Zheng Chongyue and Tan Wenyuan were both relieved.

"Dr. Guo, let me change the dressing."

"This is the emergency room. Leave these things to me," Tan Wenyuan said, offering his help very proactively.

Guo Ziyuan's diagnostic skills are really strong. His arrival in the emergency room will make my work easier, improve my resume, and may even get me admitted to the hospital!

Guo Ziyuan said, "Brother Tan, no need, I can change the dressing myself."

"The patient came specifically to see me."

Tan Wenyuan simply pushed the dressing cart away: "Hey, Dr. Guo, you're too kind."

"It's just changing the medication..."

Guo Ziyuan hadn't even expected Tan Wenyuan to be able to snatch the medicine-changing cart away, so it was too late to stop him.

"Hey, Dr. Tan." Guo Ziyuan hurriedly caught up with him.

"It's nothing, just changing the dressing..." Tan Wenyuan smiled and tilted his head.

However, before Tan Wenyuan could even take his position, Chen Qiangwei in the control room spoke up, her tone wary: "Who are you? Where's Dr. Guo?"

Tan Wenyuan hadn't expected the patient to be so nervous: "My name is Tan Wenyuan, and I'm an attending physician at this hospital."

"Director Zheng needs to speak with Dr. Guo, so he asked me to come and change your dressing."

"I'll come and see."

Chen Qiangwei said, "Dr. Tan, I only need Dr. Guo to change my dressing!"

"If Dr. Guo is busy, I can wait for him!"

Didn't Chen Qiangwei ask the attending physician to change her medication?

Of course she tried, but after trying too many times to no avail, she became distraught and hurriedly followed the procedures.

She went to the Yilan Central Hospital again, specifically to go through the procedure in the outpatient dressing room.

But after meeting Guo Ziyuan, Chen Qiangwei discovered that her ulcers no longer smelled bad!

Moreover, there is a tendency for healing.

Later, Chen Qiangwei had her medication changed by Dr. An Yue several times, but she did not develop this tendency.

If Chen Qiangwei didn't know that the key point was Guo Ziyuan under such circumstances, she might as well hang herself.

"No, it's just a change of medicine." Tan Wenyuan wanted to show off his abilities.

Unexpectedly, the procedure didn't work out with the patient.

Guo Ziyuan walked in at that moment: "Dr. Tan, let me do it. You and Director Zheng go and rest first."

"I know this patient..."

Chen Qiangwei's wound had already been reopened, and Tan Wenyuan could see the opening. He still insisted, "Isn't it all the same who changes your dressing?"

"As I said, Director Zheng has something to discuss with Dr. Guo."

Chen Qiangwei said, "Doctor, I only need Dr. Guo to change my dressing."

"He's the one who changed my dressing and cured my ulcer."

"No one else can do that!"

Tan Wenyuan said, "It's just changing the medicine, what difference does it make who gets changed?"

"I have diabetic foot ulcers," Chen Qiangwei said coldly.

Upon hearing this, Tan Wenyuan was immediately stunned.

He hadn't even put on gloves yet, and he couldn't help but rub his eyes with his hands.

In Tan Wenyuan's memory, diabetic foot ulcers were usually black and smelled foul.

However, Chen Qiangwei's soft tissue not only lacked that special flavor, but was also exceptionally pink and tender.

"You call this diabetic foot?"

"Which doctor gave you the diagnosis?" Tan Wenyuan's voice even carried a hint of mockery.

Chen Qiangwei didn't say anything, but handed over her medical record bag.

Chen Qiangwei flashed the medical record bag in the air.

She felt she had been polite enough, right?

I told you, I came to see Dr. Guo Ziyuan. What are you doing here?

Tan Wenyuan didn't even take the medical record bag, and explained in a rather professional manner: "You don't need to show it to me, you've definitely been misdiagnosed."

"Diabetic foot is incurable."

Chen Qiangwei was a familiar face at the hospital. She slapped the medical record bag in her hand and said, "I strongly request that Dr. Guo Ziyuan perform the dressing change procedure for me. Do you even understand what I'm saying?"

Guo Ziyuan had already entered the room, picked up the medical record bag, and handed it to Tan Wenyuan.

Guo Ziyuan began to order, "Dr. Tan, you go and rest first, leave this to me."

Outside, Zheng Chongyue quickly called out, "Tan Wenyuan, come out here!"

The patient has made a strong request; if Tan Wenyuan continues to stay, he will only be asking for complaints!

Even if the patient strongly refuses, if you still force yourself on them, you might even lose your license.

That's not a medical dispute; you went against the patient's wishes!

Tan Wenyuan took a deep breath before turning around and leaving.

Of course, after leaving the house, Tan Wenyuan casually opened the patient's medical record bag.

Upon opening the medical record bag and flipping through Chen Qiangwei's medical book, Tan Wenyuan was immediately struck dumb.

Tan Wenyuan's hands were trembling slightly: "Holy crap... it was Dean Xie Huangcheng who gave her the diagnosis..."

"What is it?" Zheng Chongyue certainly knew Xie Huangcheng, the head of the Department of Endocrinology and currently the vice president of Yilan Central Hospital.

Zheng Chongyue took the medical record and began to read it from front to back.

Dean Xie's medical records were written in a very standard manner.

Type 2 diabetes.

Complications of diabetes.

Type 2 diabetes with peripheral nerve damage.

Diabetic foot: gangrene on the dorsum of the foot...

……

Gangrene is usually a more severe form of diabetic foot ulcer.

"This is impossible, Director Zheng!" Tan Wenyuan felt his brain was about to explode.

"What I just saw is definitely not a diabetic foot ulcer; there are no such diabetic foot ulcers."

Although Tan Wenyuan had never been in contact with diabetic foot patients, his theoretical teachers had shown him what diabetic foot should look like when he was in school.

That has absolutely nothing to do with tender, pinkish soft tissue.

Upon hearing Tan Wenyuan and Zheng Chongyue's voices, the two doctors on duty in the internal medicine department also came closer out of curiosity.

"Let's go in and take a look." Zheng Chongyue closed the medical record book.

The door to the control room was pushed open again.

The furnishings inside were very simple, consisting of just an operating bed and a dressing cart.

The dressing bed was covered with a disposable blue operating towel, while the dressing cart was covered with a dark green wound cleaning drape.

The wound cleaning kit on the dressing cart was opened, revealing syringes, sharp blades, and a curved plate.

The cotton balls in the curved tray were soaked in dark brown iodine complex, with a few cotton balls still bearing white threads.

Wearing sterile gloves, Guo Ziyuan was carefully using tweezers to perform a 'mysterious' operation on the patient's local ulcer.

Chen Qiangwei immediately noticed four doctors in white coats walking in and frowned slightly. "Dr. Guo, could you ask them to leave?"

Upon hearing this, Guo Ziyuan paused slightly.

Zheng Chongyue quickly raised his hand and said, "I'm sorry, beautiful lady, I apologize for Dr. Tan's rudeness just now."

"However, after looking at your medical records, we became quite interested in this ulcer of yours."

"We are all professional doctors, so we would like to observe Dr. Guo's specific procedures."

Guo Ziyuan then said, "Chen Qiangwei, they won't interfere with our operation!"

"They only observe."

"But if you insist, I can ask them to leave."

Chen Qiangwei then narrowed her eyes: "Alright then, Dr. Guo."

The two doctors on duty in the internal medicine department were frantically flipping through the patient records.

As internists, they are certainly familiar with diabetic foot, a condition in endocrinology.

However, the diabetic foot ulcers they were seeing were not the diabetic foot ulcers they knew.

The diagnosis remained unchanged no matter how many times it was examined.

"How is this possible? Diabetic foot ulcers, why would it be like this?"

"Never heard of it. I've never heard of any treatment for diabetic foot ulcers either," an older attending physician murmured.

Compared to surgical procedures, internists place more emphasis on theoretical knowledge.

Theory is essentially the foundation of a plan and its principles.

There isn't even a theoretical basis for treating diabetic foot ulcers yet, so how could there possibly be a specific treatment plan?

However, the ulcers right before my eyes are a stark reality.

This ulcer is almost healed!

In fact, it's already healed.

Zheng Chongyue carefully examined the size and depth of the ulcer!

The pinkish color of the granulation tissue indicates that the soft tissue inside is fresh and tender, not necrotic, and is unrelated to gangrene.

Zheng Chongyue felt as if his head had been hit several times with a sledgehammer, and he couldn't help but ask, "Dr. Guo, isn't an ulcer that's healed by now?"

Zheng Chongyue did not emphasize diabetic foot ulcers.

He prefers to believe that it's not a diabetic foot ulcer, but rather another ulcer that has been treated and turned into its current state.

Diabetic foot ulcers are currently incurable; this is an ironclad rule in clinical medicine.

It was something Zheng Chongyue didn't even dare to think about.

Guo Ziyuan continued removing some granulation tissue, his speed unaffected: "There's an opportunity."

"If I change the dressing again, I will suggest that she go to the hand surgery department for a skin flap transplant."

Chen Qiangwei suddenly looked up, her face filled with surprise and delight: "Dr. Guo, really?"

"Can I have a skin flap transplant at a hand surgery clinic?"

"But didn't you say that my ulcer can't be cured?"

Guo Ziyuan smiled broadly: "No one is perfect, everyone makes mistakes."

"Obviously, I'm a person too."

"I also say the wrong thing and make mistakes in judgment."

"Isn't it good that I'm wrong?" Guo Ziyuan's answer was reasonable, well-founded, and understated.

Of course, Guo Ziyuan wouldn't tell Chen Qiangwei that diabetic foot ulcers could be cured.

No guide has ever written it like that!

If I say it, it will become a handle against me, and the patient might cause me trouble.

Guo Ziyuan still won't say anything, but only suggests that she try skin flap transplantation at a hand surgery clinic.

Before animal trials are completed and clinical trials have even begun, Guo Ziyuan would absolutely not dare to say that diabetic foot ulcers can be treated.

However, Chen Qiangwei's ulcers healed so well that she didn't even need to receive local injections of autologous growth factors before her skin lesions were already in a state of needing repair!

So, even though the clinical trial hasn't started yet, Guo Ziyuan can still hand her over to the hand surgery department, where they can assess whether she is a suitable candidate for flap transplantation.

Chen Qiangwei burst into tears.

She cried, tears streaming down her face, and even sounded reproachful: "Dr. Guo, you're such a liar!"

Chen Qiangwei's tone was soft and deep, as if Guo Ziyuan had let her down and had treated her badly.

"You're definitely lying!" she said, tilting her head back with a certain look in her eyes.

There was a strange sense of grievance, but also a deep sense of being moved.

Guo Ziyuan must have lied to himself, but he did manage to heal himself; however, he couldn't give a definite answer.

Guo Ziyuan chuckled softly: "Don't say that. How can a wrong judgment be considered lying?"

"Aren't you excited!"

"Don't move your feet, or you'll interfere with my actions!"

Guo Ziyuan continued operating with utmost care, so he had no time to notice the other four people in the control room who were almost petrified!

"Okay!" Chen Qiangwei also realized something.

There are some things that Guo Ziyuan cannot answer definitively; you need to consider them carefully yourself.

The conclusion that diabetic ulcers cannot be cured is not drawn by Guo Ziyuan, but may be a medical rule.

The fact that so many doctors I've met say this proves that it's a conceptual thing that everyone believes in.

Guo Ziyuan's skills are good, but he's still quite young!

Seniority is important in every place.

Even with great ability, one needs just the right evidence and the right approach to overthrow the existing obstacle.

Having figured this out, Chen Qiangwei asked again, "Dr. Guo, are there any other doctors I can consult for treatment of this ulcer?"

Chen Qiangwei began to take a roundabout approach to achieve her goal.

"The most important thing to see is an endocrinologist; blood sugar control is the top priority."

"Secondly, once the ulcer has almost healed, the skin defect can be treated."

"Treating skin defects is a specialty of hand surgery or microsurgery."

While carefully cleaning the fine structures, Guo Ziyuan used tweezers to tap the curved plate, flicking away the soft tissue on it.

"You can go and try your luck." Guo Ziyuan's expression and eyes were exceptionally calm.

Chen Qiangwei finally felt confident: "I understand, Dr. Guo."

Guo Ziyuan only felt that this patient named Chen Qiangwei was quite knowledgeable; otherwise, he wouldn't have bothered to deal with her so easily.

Guo Ziyuan didn't want to dig a hole for himself.

It is a fact that Guo Ziyuan is unable to cure diabetic foot ulcers, a fact that everyone acknowledges.

If you don't have the ability, but you promise a patient that you can cure them, you're just asking for trouble.

Of course, if you keep saying you can't cure it, but you accidentally do, no one will say you did anything wrong...

The patient doesn't know how, the superiors don't know how, the colleagues don't know how, and the family members don't know how.