Before debriding the hand, Liu Banxia first treated the three small burn wounds on the young man’s chest. Of all debrident surgeries, burn debrident is arguably the most complicated, and the patient experiences the most pain.
The last ti Liu Banxia debrided a patient infected with a flesh-eating bacterium, it could have been called a super debrident; this ti was almost the sa.
The young man was fortunate for now. Once he completed the preliminary surgery, he would truly experience the pain each ti his dressings were changed.
The principle for treating burn wounds is to debride from the outside in and from shallow to deep, removing all devitalized tissue and foreign objects.
But it wasn’t as simple as just cutting away everything indiscriminately. Burn patients often have blisters. These blisters only needed to be drained by making an incision at the base. The epidermal layer of the blister itself had to be preserved, as it helped protect the wound.
The three burn wounds on the young man’s chest were not very large, and Liu Banxia dealt with them all in less than twenty minutes. He himself felt he was a bit slow, but others saw it differently.
They had already been impressed by Liu Banxia’s speed in bone setting and tendon suturing. But could he really perform burn debrident this quickly too?
This wasn’t a simple task of just removing the burned dermis; so devitalized tissue also had to be excised. He also had to ticulously cut away the dead tissue to expose a fresh wound surface.
Others would surely deliberate carefully, proceeding bit by bit. But in Liu Banxia’s hands, he worked swiftly, applied ointnt, and was done.
The hardest part was debriding the burn on the young man’s hand. Liu Banxia even did a few stretches before he began.
"Are the burns on his hand too severe? I don’t even know if the fascia has been damaged," Liang Xiaolin expressed her concern.
"We can’t worry about that now; we have to proceed as quickly as possible. We’ve already wasted so much ti. We need to finish the debrident within an hour," said Liu Banxia.
Beneath her mask, Liang Xiaolin’s mouth fell open. With such severe burns, he planned to finish within an hour? This was an entire hand, not just a finger!
While Liu Banxia worked diligently in the operating room, Xu Chengjun, outside, was equally worried about the firefighter.
On the way back, he had assessed the young man’s injuries. The first thought that had co to his mind was that such an injury could only be handled by Xie Chunli, the director of the city hospital’s burn departnt.
At the sa ti, he anxiously hoped the surgical teams from other hospitals providing support would arrive quickly. Every minute the patient’s treatnt was delayed increased the risk to his life.
As they waited anxiously, the supporting doctors from various hospitals began to arrive.
The first to arrive were from the Second Hospital. To Xu Chengjun’s surprise, Zhou Shuwen was leading their team. This significantly boosted his confidence. The doctors from the Second Hospital were general surgeons and cardiothoracic surgeons. After a brief exchange, they imdiately entered an operating room.
Just as that team went in, doctors from the City Hospital also arrived at the District Hospital. This group included Xie Chunli, the director he had been anxiously awaiting, along with another physician.
"Director Xie, you’re finally here! A young firefighter has very serious burns on his hand," Xu Chengjun hurriedly said.
"We rushed here as soon as we received your call. I heard Zhou Shuwen ca directly to you, so our other doctors went to the Traditional Chinese dicine Hospital," said Xie Chunli.
"This is Qiu Wei, an attending cardiothoracic surgeon. His skills are excellent. If there’s a suitable surgery, don’t hesitate to have him assist. Where’s the young firefighter? I’ll check his condition first."
"Director Xie, the young firefighter also has other injuries: a proximal hurus fracture and ruptured tendons. He’s currently in the operating room for bone reduction and tendon repair. Please, catch your breath first; we’ll go in shortly," Xu Chengjun said.
"We’re treating many burn patients here as well. Could you take a quick look around and see if any cases are being managed inadequately? We want to address any issues imdiately to avoid delaying their treatnt."
Xie Chunli didn’t waste any words and went directly with Xu Chengjun into the temporarily sectioned-off burn patient ward. Since many patients had extensive burn surfaces, they needed to be isolated from one another to prevent cross-infection.
"Your current treatnt protocols are quite good. If you can maintain good environntal control, many patients have a very hopeful prognosis. However, so patients will undoubtedly require skin grafting. For now, let’s focus on their initial recovery," Xie Chunli said after a glance around.
"Sigh, all available doctors from our hospital are involved. Otherwise, we simply wouldn’t have enough people," Xu Chengjun responded.
"Thankfully, we’ve managed so far. But if any mismanagent on our part were to delay a patient’s treatnt and cause adverse effects, I’d never be able to forgive myself."
"Your district hospital doesn’t have that many staff. How did you end up admitting so many patients?" Xie Chunli curiously asked.
"It was a coincidence. A friend from the Second Hospital was here helping with a small-incision appendectomy, and I brought him to the scene as well. Their triage skills are strong, and they process patients quickly. That’s how we ended up with more patients here," Xu Chengjun replied.
"You really don’t miss any opportunity to promote your hospital, do you? It’s a good thing you managed to handle it all. Otherwise, you would have really been in for it," Xie Chunli retorted helplessly.
Of course, Xie Chunli saw through Xu Chengjun’s little sche. This incident was bound to attract significant attention from all sectors. If the District Hospital perford exceptionally, the benefits would be imnse.
"Alright, let’s go see that young firefighter now," Xie Chunli said.
"Okay, I’ll take you there right away," Xu Chengjun quickly answered.
He estimated Liu Banxia should have finished the fracture reduction, tendon repair, and debriding the chest burns by now. Going over at this mont wouldn’t keep Director Xie waiting too long; the timing should be perfect.
"Thank goodness! Although the hand burns are severe, all the tendons were preserved."
Just as Xu Chengjun and Xie Chunli walked into the operating room, they heard Liu Banxia’s words.
Xu Chengjun was startled. Has Liu actually finished debriding the hand already? He isn’t just being reckless, is he? If it’s not done properly, the consequences for the patient will be even greater!
"Can you stop being so smug? What’s the next step? The fingers have been debrided to this state; in so areas, the bone is exposed. Only the thumb is slightly better off. What about the other four?" Liang Xiaolin, who hadn’t noticed them enter, asked with a frown.
"I don’t know what others would do, but ordinary skin grafting definitely won’t suffice here. I reckon so advanced techniques will be needed, and he’ll likely have to endure more," Liu Banxia considered and responded.
Xu Chengjun was about to speak, but Xie Chunli gestured for him to wait. Although he hadn’t seen the hand yet, he was very curious.
"What are you being so mysterious about? You’ve done your part. If you don’t know what to do next, don’t hold up his treatnt," Liang Xiaolin said.
"An abdominal pedicled flap. I imagine that’s roughly what will be done," Liu Banxia stated.
"Wrap each finger individually? Would that even work?" Liang Xiaolin asked.
"Silly. You wrap them all together first, then separate them gradually: one becos two, two beco four. This way, the patient’s recovery will also be faster in the later stages, reducing the risk of infection," Liu Banxia replied.
"That actually sounds plausible. It would be like managing a single large wound surface then," Liang Xiaolin pondered for a mont and then nodded in agreent.
Xu Chengjun was at a loss for words. These two had been a trendous help today. But discussing this right in front of Director Xie... wasn’t this a bit like teaching an expert his own trade?
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