My Medical Skills Give Me Experience Points Chapter 1445 - 577: Nerve Issues? Current State of Medicine

Under normal circumstances, if the bones of two toes are not fused together and each has an independent and complete skeletal structure, surgery is needed only to separate them from the middle. However, since the condition is inherently a deformity, various unexpected situations can occur during the actual surgery. For instance, the blood vessels of the two toes may be intertwined, or only one artery may supply blood to both. In such cases, the surgery becomes more complex and requires artificial bridging to reconstruct an arterial vessel. In fact, the Anterior Tibial Artery and the dorsalis pedis artery are the main sources of blood supply to the toes. As for the venous return, it originates from the great saphenous vein and the small hidden vein. The posterior tibial artery is one of the two major terminal branches of the popliteal artery and can serve as a source for bridging and reconstructing blood vessels if necessary. Generally, it supplies the sole, and is used less frequently during surgery. Zhou Can is uncertain about the specific surgical circumstances of this patient. One thing is certain, the surgery shouldn’t be too difficult; otherwise, it would be performed personally by him or Dr. Xu. After removing the bandages, the sutured wound can be seen. The suturing is quite neat, with no skin grafting, only gathered suturing. Patients with means will receive skin expansion therapy for some time before the surgery. However, since this is just a minor surgery and patients come from various places within the province, comprehensive preparation work often cannot be accomplished. Requesting the patient to make multiple hospital visits is unrealistic. Doctors naturally wish to perform the surgery as perfectly as possible, but patients, mindful of financial capacity and time costs, often find it difficult to accept. Post-operative gathered suturing is quite common. The skin itself is highly resilient and extensible. With some recovery time, it can automatically grow and cover the entire wound. The only precaution during this time is to prevent infection. Moreover, post-operative hospital observation usually lasts only about one to two days. The remaining time involves prescribing medication for the patient to care for themselves at home. Especially in major hospitals like Tu Ya, where bed availability is tight, it’s difficult to allocate limited bed resources to minor surgery patients. This patient chose to undergo surgery at Tu Ya’s Emergency Department mainly due to Zhou Can’s reputation. Normally, toe web surgery is completed by General Surgery. The operating room of the Emergency Department functions now as an all-department surgical room, daring to undertake almost every surgery except Level 4 surgeries and obstetrics procedures. Surgery primarily divides into two technical parts: the basics of surgery, which include incision, suturing, hemostasis, and anastomosis, among others; and surgical experience. Normally, unless the surgery is exceptionally difficult, all surgeons can transform into versatile warriors. However, in practice, such all-rounder surgeons are rare. Asking a surgeon who usually only performs General Surgery to conduct a thoracic surgery for a heart operation is basically lethal for the patient. This is why Cardiothoracic Surgery and Neurosurgery are always regarded as the pinnacle of surgical fields. Because these areas involve high technology precision surgeries. Only those with high surgical competence and rich experience in these fields are qualified. The nurturing period for cardiac and neurosurgeons is not less than eleven years. Meaning, from an ordinary novice doctor to being trained to independently complete a cardiac surgery takes at least eleven years. In reality, this training period is much longer; without fifteen to twenty years of surgical experience, senior doctors wouldn’t dare let you preside over surgery alone. Lives are at stake. From the suturing technique and neatness, this patient’s toe web surgery appears to have been done by a relatively experienced surgeon, as some meticulous details were handled quite well. "Is it this toe that feels numb?" Zhou Can took a sterile cotton swab and touched the patient’s right toe. To be precise, this is the third toe. Typically, toes two to five are most prone to deformity and webbing. The first toe is the innermost, the thickest one. It’s the largest toe, and the likelihood of webbing with the second toe is very small. This female patient mainly has deformity webbing between the third and fourth toes of the left foot. "Yes, it’s this one," the girl nodded. A family member stood by the bedside accompanying her. Judging by appearance and age, the companion should be the girl’s mother. However, this woman was very shy and simple, seldom speaking, merely standing by with a smile watching Zhou Can examine her daughter. The patient’s father only appeared on the day of surgery, presumably headed home to work and earn money after seeing the surgery finished. In most families, the men are the main pillars and economic supports. "Close your eyes," Zhou Can instructed the patient. "Do you feel anything?" He touched the patient’s third toe of the left foot again with the cotton swab. "A little, not very apparent." "Which toe am I touching? Left or right?" "Right!" "And now?" "Left!" "Does the sensation in this left toe feel different from that in the right one?" "Yes! The feeling is very distinct, I can tell you’re touching my toe with the tip of the cotton swab." The girl’s response was precise. This facilitated Zhou Can’s accurate diagnosis. The worst is asking a question and getting three unknowns, ambiguous responses, or hesitations from patients. It really can be maddening. Now it can be basically determined that the patient’s third toe of the left foot has issues.