CHAPTER 189: FIRST BATTLE OF VASCULAR SUTURE 189

The mode of anesthesia chosen was still brachial plexus anesthesia, and an inflatable tourniquet was also bound to the patient’s left arm.

"Thankfully, you punctured yourself with the tip of the knife, making it less complicated for us to handle," Liu Banxia said while cleaning the patient’s wound.

"However, since you’ve also severed your tendon, there’s definitely going to be a long recovery. While it won’t impact your normal life in the future, you still need to be mindful when lifting heavy objects with your left hand."

"Doctor, could you not inform my family?" the patient asked.

"It depends on the circumstances. If there are no postoperative complications and you can pay the surgical fee, we usually won’t contact them," Liu Banxia responded.

"But, aren’t you not from Binhai City? It’s better to leave us a reliable relative’s contact information in case of emergency. Don’t worry about these things; it’s not about losing face."

"Think about it, can you really hide the wound on your wrist from your family when you return home? If you keep it from them, they’re likely to worry more. Even if you don’t want to mention your girlfriend, you could say it was from a fight."

"Doctor, that won’t work. I can’t pretend that I came all the way to Binhai City to brawl," the young man answered with a wry smile.

"Eh? Is that so? But are you sure you can afford the surgery fee? It’s quite a sum of money these days," Liu Banxia added.

"I’ll contact some of my classmates. If possible, can you please try to keep it from them if you can?" the young man implored.

Liu Banxia nodded. "No problem, you’re an adult, and we need to respect your decision. Next, you can chat with others. I still need to suture your blood vessels, and we’ll aim to get it right on the first attempt."

The young man paused, a bitter smile forming on his face. In all the talking, he’d forgotten about the crucial task of suturing his blood vessels.

Suturing blood vessels is a more delicate process than suturing tendons. First, you need to isolate the two ends of the vessel, then check the vessel’s blood flow.

If the bleeding isn’t robust, there must be a clot that hasn’t been flushed out, requiring a more meticulous cleanup. Only after cleaning both ends can you proceed to the next step.

After inspecting both ends of the vessels, Liu Banxia carefully peeled off the adventitia (outer membrane) of the blood vessel with a small pair of scissors. This was also a necessary cleaning step; otherwise, the adventitia could easily get sutured into the vessel and form a blood clot.

After removing the adventitia, he also trimmed the ends of both severed parts, which would facilitate suturing and healing.

To ensure no blood clots remained in the vessel, he carefully flushed both severed ends twice with heparin saline. All these steps were preparatory work done before the actual suturing, none of which could be neglected.

Every step in the operation is crucial. Any small oversight could cost the patient their life. No surgeon could handle such a burden.

Once all preparations were completed, Liu Banxia flexed his wrist before commencing the actual suturing.

Liu Banxia adopted the three-point triangulation suture method, thus preventing the likelihood of accidentally suturing the opposite wall of the vessel.

Aside from the patient, everyone else in the operating room was observing Liu Banxia’s suturing. The only word they could use to describe him was—stable.

Those who work full-time in operating rooms are quite experienced; they’ve participated in far more surgeries than the average surgeon.

Even with the aid of a microscope, suturing blood vessels isn’t easy. One needs to monitor and feel their actions continually. If your movements aren’t gentle and precise enough, you could rip the vessel apart.

For the patient, the later blood flow is restored, the greater the impact on the hand. Unlike a game, surgeries do not have the option to save progress.

Moreover, Liu Banxia had no surgical assistant today; the scrub nurse was acting as his first assistant.

This was the fundamental issue. If he had a professional surgeon as an assistant to help Liu Banxia by holding the sutures or something similar, his current stability might be excusable. But now, the nurse only acted on Liu Banxia’s instructions.

What did this represent? It indicated that Liu Banxia, the operating surgeon, was actually adapting his suturing to accommodate his assistant, thus giving people a sense of stability. But in reality, his speed was not slow.

"OK, let’s see how well we’ve done," Liu Banxia said, finishing his last knot.

No matter how fast you suture, if you don’t properly suture the blood vessels, it would all be in vain; everything would have been pointless.

Liu Banxia first released the distal vascular clamp, checked the anastomosis, and found no leaks. He then released the proximal clamp. This time, he had to examine not only the anastomosis but also the patient’s hand for color, temperature, and pulse.

Everything seemed fine, and Liu Banxia let out a breath. He hadn’t embarrassed himself today. There were no incidents requiring a reinforcement suture. A reinforcement suture in vascular anastomosis is like having to widen an incision that was initially too small.

Although no one would comment on it, as it’s a common occurrence in surgeries, it still doesn’t look good. Especially with a reinforcement suture for vascular anastomosis, it’s easy to inadvertently incorporate the adventitia and form a thrombus.

The subsequent tendon suturing was even more relaxed. Liu Banxia had performed tendon suturing three times before.

This time, what he demonstrated to Wang Lei and the others was real speed. The process was a genuine delight to watch.

After finishing the suturing, he released the tourniquet again, irrigated the wound thoroughly, and achieved hemostasis for two minor bleeding points. After another careful irrigation, he proceeded to suture in layers, covering it with iodophor gauze and finally a sterile dressing.

DING! Daily Task completed (20/20).

Obtained 300 Experience Points, 5 Glory Points.

Emergency Patient Admission Task completed. Obtained 200 Experience Points, Suture Technique Skill Proficiency +300, Dressing Change Skill Proficiency +100, Diagnostics Skill Proficiency +50.

Task Rating: Perfect. Obtained 500 Experience Points, Suture Technique Skill Proficiency +500, Dressing Change Skill Proficiency +200, Diagnostics Skill Proficiency +50, Glory Points +6.

"Shoutian, have you been finding time to practice? I noticed that your skills seem to have improved quite a bit," Wang Lei began to speak while Liu Banxia was still reveling in the joy of the system rewards.

"Take the situation just now, for instance. I actually wanted to chat with the patient to distract him, but I simply couldn’t take my eyes off how quickly you were suturing."

Liu Banxia stretched lazily. "Everyone, be my witness, this isn’t me hitting on Old Wang. Don’t let Sister Li get the wrong idea when you go back."

Wang Lei glared at him. This guy really could talk nonsense with a straight face.

Liu Banxia glanced at the operation time: 53 minutes. He knew he could have done it faster if he had a decent first assistant; that was what slowed him down.

Nevertheless, he was satisfied with this achievement. Despite merely suturing a radial artery, this marked his first real step into vascular suturing.

That old saying still holds: practice in the dream space and operating on a real patient are two very different matters.

"No need to dwell on it. You can rest in the ward later. What’s past is past. I can give you an extra day to sort out the fees; you can think it over tomorrow," Liu Banxia said, turning his gaze back to the patient.

The patient nodded.

"Thank you all. I’ll take him back to his ward now, so I won’t help you all clean up," Liu Banxia said with a smile.

"Off you go. Your quick surgery saved at least half an hour," Wang Lei replied.

Liu Banxia had actually wanted to console the lovesick young man, but then he thought about his own lonely existence. Who was he to offer advice?

Once they reached the ward, he advised the patient to take a painkiller if the pain got unbearable once the anesthetic wore off. That was the best comfort he could offer at that moment; there was nothing else.

"You finished so quickly?" Shi Lei looked disbelieving when he saw Liu Banxia return.

"Just one blood vessel, one tendon. If you, Boss, were my first assistant, I could have finished at least five minutes earlier," Liu Banxia said.

"Keep showing off. The four drunks were just treated," Shi Lei said, annoyed.

"Hehe, I love working shifts with you, Boss. I’ll have to be out for about two hours tomorrow morning. I’ve already informed Director Zhou, so you’ll have to work a little harder then," Liu Banxia said.

"Where are you going? Director Zhou actually gave you leave?" Shi Lei quizzed, clearly surprised.

"The patient with the finger infected with flesh-eating bacteria is facing some psychological hurdles. I’ll try my best to help him cope tomorrow," Liu Banxia explained.

Shi Lei nodded in understanding. For patients, psychological counseling is also very important. The recovery period for that particular patient would be lengthy, necessitating a time of adaptation and rebuilding confidence.

If the physical wounds healed but the psychological ones didn’t, it could bring disaster to the entire family. Sadly, the hospital had seen far too many such cases.

Sitting down to the side, Liu Banxia began to ponder.

Based on the rewards the system had given him recently, he realized that the only way to gain a large amount of experience was to continually challenge more difficult tasks.

Suturing the tendon and blood vessel today had only rewarded him with so few suture skill proficiency points. He guessed it was a bit more only because it involved vascular suturing.

His understanding of the system had been too simplistic. Although it existed as a medical aid, it wouldn’t let you reap without sowing.

It provided real assistance. He was only at this level now, yet leveling up was already proving to be a challenge, and the rewards were diminishing.

He guessed that even when his suturing skill reached level three, performing this kind of vascular suturing wouldn’t give much experience. More difficult suturing, like nerve suturing or microvascular suturing, would probably be the only way.

Thinking about this, he came to terms with it. After all, he did have the system, which already gave him too many advantages over others. If he wasn’t willing to put in the hard work, then he was truly hopeless.

His first attempt at vascular suturing today was very successful, and Shi Lei hadn’t even come into the operating room to supervise. This was a form of trust and recognition of his abilities, which was equally precious.