39: Chapter 39 Lu Chen's Help
Lu Chen stood to the side, looking up at the patient on the gurney.
The system activated automatically.
[Eye of Truth scan complete]
[Patient information: Male, 26 years old]
[Chief complaint: Sharp force injury to the right upper limb and chest wall, continuous bleeding for approximately 15 minutes]
[Eye of Truth diagnosis: Approximately 18 cm oblique incised wound on the lateral side of the right upper arm, reaching the muscle layer, with partial triceps brachii avulsion; one approximately 7 cm incised wound at the 6th intercostal space of the right anterior axillary line, about 3 cm deep, without penetrating the pleura; one approximately 5 cm superficial incised wound on the dorsal side of the right forearm, affecting only the subcutaneous fat layer]
[Danger level: Orange (medium-high risk)]
[Current symptoms: Active bleeding, estimated blood loss of approximately 400-500 ml, heart rate slightly elevated at 102 beats/min, blood pressure slightly low at 105/68 mmHg, signs of early hypovolemic shock]
[Recommendation: Immediate hemostasis, Debridement, and Suturing. Prioritize the deep wound on the right upper arm; the triceps brachii avulsion site requires precise alignment and repair, otherwise, the extension function of the right arm will be affected. The chest wall wound needs to rule out the possibility of delayed pneumothorax; it is recommended to re-examine the chest X-ray within 6 hours post-surgery]
[Warning: The wound on the right upper arm is adjacent to the path of the radial nerve. During Debridement and Suturing, care must be taken to avoid secondary damage to the radial nerve; otherwise, it may lead to wrist drop deformity]
Lu Chen's eyes narrowed slightly.
Three knife wounds; the most troublesome one is the one on the right upper arm.
With the partial triceps brachii avulsion and the proximity to the radial nerve, this Suturing is quite difficult; not just any doctor can handle it well.
The gurney was pushed into the Debridement Room.
Zhou Wenjie had already started washing his hands in preparation for the procedure.
Lu Chen followed him inside.
He Wenbin and Wu Fan also followed, standing at the door to observe.
"Dr. Zhou, can I help?"
Lu Chen spoke up.
Zhou Wenjie looked back at him, hesitated for half a second, and then nodded.
"Fine, you can be the assistant. Help me expose the surgical field."
"Okay."
Lu Chen quickly washed his hands, disinfected, and put on gloves.
The two stood on the same side of the gurney and began to treat the wounds.
The Nurse had already established intravenous access for the patient and started fluid replacement.
Zhou Wenjie picked up an iodophor cotton ball and began the Debridement.
"Which wound should I treat first?" he muttered to himself.
Lu Chen said softly from the side.
"I suggest treating the one on the right upper arm first. It has the most bleeding, and there is muscle avulsion."
Zhou Wenjie looked at the 18 cm wound; blood was still oozing out.
"Hmm, I think so too. The one on the upper arm is the most troublesome."
He picked up a hemostat and began to clear the foreign objects and blood clots from the wound.
Lu Chen helped to spread the edges of the wound, exposing the deep tissues.
The system's prompt information kept refreshing at the edge of his vision.
He could see the position of the radial nerve clearly; it was in the deep, medial part of the wound, about one centimeter away from the muscle avulsion site.
This distance was very close.
If the angle was incorrect during the muscle layer Suturing, or if the needle depth was not well controlled, there was a possibility of accidentally injuring the radial nerve.
Zhou Wenjie began the muscle layer Suturing.
His technique was not bad; the skill level of a provincial silver medal winner was indeed on point, and the first few stitches were very steady.
But Lu Chen noticed that when Zhou Wenjie was dealing with the area near the radial nerve, the angle of the needle entry was slightly off.
It wasn't a technical issue; it was that he couldn't see the exact position of the radial nerve.
Without system assistance, it is indeed very difficult to pinpoint a nerve in a bloody, mangled wound with the naked eye alone.
Lu Chen thought for a moment, then used a hemostat to gently adjust the exposure angle.
"Dr. Zhou, at this position, the radial nerve should be about one centimeter medially. I suggest adjusting the needle entry angle about 5 degrees outward."
Zhou Wenjie's movements paused for a moment.
He lowered his head and carefully looked at the direction Lu Chen pointed.
"How do you know the radial nerve is there?"
"Calculated from anatomical structures, combined with the direction and depth of the wound, the probability of the radial nerve being in this position is the highest."
Lu Chen couldn't say it was marked directly by the system, so he could only use a reasonable explanation.
Zhou Wenjie was silent for two seconds, then slightly adjusted his needle entry angle.
"What you said makes sense. I'll be careful."
For the next few stitches, Zhou Wenjie Sutured even more carefully, deliberately avoiding the area Lu Chen pointed out.
The muscle layer Suturing took about fifteen minutes.
Then came the Suturing of the subcutaneous tissue and skin.
After finishing the right upper arm, the two then treated the wounds on the chest wall and forearm in turn.
Although the chest wall wound looked scary, it did not actually penetrate the pleura, so Debridement and Suturing were sufficient.
The one on the forearm was simpler, just a superficial subcutaneous incised wound.
The entire treatment process took about forty minutes.
The man on the gurney remained conscious throughout the process; although he was sweating profusely from the pain, he stubbornly didn't make a sound.
Lu Chen noticed this detail; this person's endurance was extraordinary.
Halfway through the treatment, the girl was peeking at the door of the Debridement Room but was stopped outside by the Nurse.
"You cannot come in; wounds are being treated here."
"But my brother..."
"Your brother is fine; he is being treated. You wait outside."
The girl bit her lip, and tears still couldn't stop falling.
But she didn't try to force her way in again, just stood on tiptoe and tried hard to look inside.
The wound treatment was finished, and Zhou Wenjie took off his gloves.
"Alright, the wound Suturing is complete. Subsequent dressing changes and suture removal will be needed. Additionally, I recommend getting a chest X-ray to rule out the possibility of delayed pneumothorax."
The patient leaned on the gurney and let out a long sigh.
"Thank you, Doctor."
His voice was a bit hoarse, but very steady.
Zhou Wenjie nodded and turned to look at Lu Chen.
"Your reminder about the position of the radial nerve just now was a huge help."
"You are too kind, Dr. Zhou."
"It's not being kind. If I hadn't noticed that position, it would indeed have been possible to injure the nerve during Suturing, and that would have been troublesome."
Zhou Wenjie's expression was very serious when he said this.
The two began to tidy up the instruments.
The girl at the door was finally let in by the Nurse; she trotted all the way to the side of the gurney and grabbed her brother's hand.
"Brother! Are you okay? Does it hurt?"
"I'm fine, just superficial wounds. Stop crying."
"What do you mean superficial wounds? You lost so much blood!"
The girl's tears welled up again; she crouched beside the gurney, buried her head near her brother's arm, and her shoulders shook.
The injured man sighed and patted her head with his uninjured hand.
"Alright, alright, stop crying, it's embarrassing."
"You're the one who's embarrassing, going out and getting hacked up like this..."
As she spoke, her voice became slurred, clearly unable to continue because of crying.
Lu Chen silently tidied up the instruments on the side, not disturbing the siblings.
Just at this moment, a chaotic sound of footsteps came from the corridor outside the Debridement Room.
Very heavy, very hurried, and more than one person.
Then came a very aggressive voice.
"Where is he? Which room is he in?"
Lu Chen looked up.
Zhou Wenjie also frowned.
The door to the Debridement Room was pushed open from the outside.
Three people stood at the door.
They were all men, looking like they were in their early twenties, dressed in gaudy clothes, with thick necklaces around their necks; one look and you could tell they weren't good people.
The one leading them had a buzz cut, with an unlit cigarette in his mouth, and his eyes looked very fierce.
He swept a glance at the situation inside the Debridement Room, and his gaze landed on the man on the gurney.
Then he smiled.
The smile was not pleasant, carrying a trace of malice.
"Yo, he really is here. You ran pretty fast."