My Medical Skills Give Me Experience Points Chapter 1351 - 535: Accident Triggered by Anesthesia, One Person’s Strength Is Ultimately Limited_2

"When I examined the patient earlier, I found that pressing the swollen area on the left side yielded a stone-hard sensation, and his limbs felt cold. This indicates the muscle tissues have already necrotized, and the optimal treatment window has long passed."

During the examination, though it appeared as though he was merely pressing around casually, Zhou Can, leveraging his extensive diagnostic experience, swiftly assessed the patient’s critical condition.

"That’s absolutely correct; your analysis is remarkably pertinent. You suspect the kidney failure is a direct consequence of the compression injury on the limb, isn’t that so?"

Director Lou nodded in profound agreement upon hearing Zhou Can’s assessment.

The young doctors in the vicinity were diligently taking notes, meticulously recording Zhou Can’s analysis for their future reference and as a valuable learning experience.

"Because of the muscle necrosis on the left side, the swelling becomes hardened, leading to significant local exudation or bleeding, which ultimately results in a decrease in overall blood volume. The patient’s critically low blood pressure serves as the most definitive evidence of this. As the overall blood volume diminishes, renal blood perfusion is reduced, resulting in ischemia. Furthermore, toxic substances released from the necrotized muscle tissues due to compression exacerbate the renal poisoning. At this stage, myoglobin deposits occur, directly obstructing the renal tubules and culminating in the patient’s acute renal failure."

Zhou Can meticulously detailed the complete progression of the renal failure, deeply impressing Director Lou with the depth of his analysis.

The other doctors and nurses gazed at Zhou Can, their eyes brimming with admiration and profound respect.

"It’s truly a tragedy that the patient is so young, with his life's trajectory so severely disrupted. Had the complications been addressed promptly post-surgery, there might have been a viable chance to save him. Now, he has entered an irreversible stage of acute renal failure and respiratory failure; it is beyond remedy, a gravely ill individual."

Zhou Can did not explicitly state that the Third Hospital had mishandled the patient’s critical care and delayed life-saving treatment.

However, the deficiencies and errors within the Third Hospital’s treatment process were clearly discernible from his detailed analysis.

This was, in essence, a classic, severe medical accident.

...

In the evening, after concluding his surgeries in the Emergency Department, completing his ward rounds, and savoring the delicious meal delivered by Su Qianqian, Zhou Can hurried towards the Cardiothoracic Surgery department.

A multitude of urgent matters awaited his immediate attention.

The elderly cadre had already tentatively agreed to undergo surgery; the precise methods by which his family was persuaded remained unclear.

This situation is quite typical within hospitals; families and patients are generally compelled to adapt to the hospital’s established diagnostic and treatment protocols, rather than pursuing their own specific desires.

This particular old cadre’s medical expenses could be reimbursed almost entirely, and his family possessed substantial financial resources. His daughter-in-law was particularly insistent on selecting the safest, 'best' surgical approach, advocating for vascular stenting to resolve the underlying issue.

However, the medical team could not readily agree with her proposed course of action.

The sheer number of stents that would need to be implanted was a significant concern. Moreover, the anticipated effectiveness of such an approach was questionable.

Opting for an artificial blood vessel to perform a bypass procedure would provide a more direct and comprehensive solution. This method presented considerably lower costs, was far more straightforward and labor-saving, and offered minimal concerns regarding potential future complications with the vascular segment. The primary drawbacks associated with artificial vessels were the potential for aging over time and leakage resulting from improper anastomosis.

Let us first consider the issue of aging.

The projected lifespan of an artificial blood vessel is typically at least ten years, with higher quality ones enduring for over two decades. In reality, utilizing one for thirty years would likely present no significant issues.

This is largely due to the fact that it is sealed within the human body.

Apart from potential corrosion by blood and bodily fluids, it essentially experiences no degradation from exposure to external air. This undoubtedly contributes significantly to extending its operational lifespan.

The old cadre was already sixty-five years old; even if he were to live to the age of one hundred, he would have only thirty-five years remaining. A replaced artificial vessel should prove adequate for that duration.

Even if a problem were to arise, he could always return to the hospital for a replacement.

Patients who develop arteriosclerosis and experience systemic conditions of this nature seldom live to reach a centenarian age. Often, reaching eighty years old is considered a significant benchmark of longevity.

The patient’s abdominal aorta, along with his cardiovascular and cerebral arteries, would inevitably continue to deteriorate. At that point, a cerebral hemorrhage or myocardial infarction could potentially prove fatal.

Within the operating room of the Cardiothoracic Surgery department, Zhou Can personally undertook the surgery on this elderly cadre.

The patient’s family anxiously awaited the outcome outside the operating room doors.

The specifics of how Xue Yan managed to communicate with them were unknown to Zhou Can. He was only aware that the old cadre had specifically requested that Zhou Can personally perform his surgery.

The more prominent the patient, the greater their demand for treatment from esteemed and renowned physicians.

Following Zhou Can’s intraoperative examination, he ultimately chose a 38cm long, approximately 8mm diameter artificial vessel to create a bypass from the patient’s right femoral artery to the popliteal artery.

Given the observed necrosis and blackening of the right foot’s fourth toe, its preservation was deemed impossible.

Prior to the operation, with both the patient and their family giving their consent, an amputation of the toe was performed.

This decision was made to minimize the potential harm to the patient.

Other medical facilities had proposed amputating the entire right leg to preserve the patient's life.

With Zhou Can's involvement, excising only a single toe represented the most favorable outcome possible.

Post-surgery assessments confirmed the restoration of blood flow in the right foot, encompassing the popliteal artery and the dorsal pedal artery. A visible improvement was observed as the skin surface of the patient's right foot began to regain a hint of its natural color.

In contrast to its former pallor and coldness, it now exhibited a faint trace of blood.

This signified that the blood circulation in the right foot had been successfully re-established.

With proper nourishment and the unimpeded flow of Qi and blood, the right foot should no longer face the threat of further necrosis.

"Post-operation, ensure comprehensive anti-infection measures are in place and diligently monitor the condition of the right foot. Should any signs of ischemia or further necrosis arise, address them immediately,"

Zhou Can directed the circulating nurse.

"Understood."

The circulating nurse held Zhou Can in high regard.

The Cardiothoracic Surgery operating room was, in essence, Zhou Can's domain. The nursing staff and physicians there held his exceptional skills in high esteem and placed their complete trust in him.