Free Web NovelChapter 562: Chapter 257: Skin Grafting, Promotion to Associate Chief Physician (2)
He carefully separated the lesion bit by bit and then excised it.
The entire process seemed extremely calm.
While cutting the lesion, he went all the way to the buccinator muscle, removing all the diseased tissue.
At this point, a large open wound was revealed.
He was a little at a loss regarding the wound treatment.
If he sutures it directly, he could close the patient’s wound, but after healing, the young man would find it very difficult to open his mouth.
Eating, speaking, and yawning will become obstacles.
Because his mouth would only be able to open a little bit.
The main issue was that the lesion was too large, creating a large wound after being excised.
What should be done?
Li Jingsheng is a responsible doctor; not only does he need to ensure the success of the excision, but he must also consider the patient’s postoperative quality of life.
The surgery should not negatively affect the patient’s quality of life after the operation.
"Young man, you’ve seen the large size of the tumor that was cut out. We now need to suture the wound. If we sew it up directly, you will have difficulty opening your mouth for eating and speaking in the future, you could only open a little. I have an alternative: graft a piece of skin from your arm. Blink if you agree."
Li Jingsheng asked for the patient’s opinion.
The young man blinked to indicate his agreement.
To avoid postoperative disputes, Li Jingsheng recorded the entire process.
It was not his first time excising a tumor.
However, taking and grafting skin during surgery was a first for him.
Fortunately, his suturing skill was already quite honed, as were his incision and separation skills, enabling him to perform what seemed like a not overly complicated surgical task.
If he had known that skin grafting was needed, he would’ve charged at least five or six hundred more yuan.
It’s too late now, he considered it an act of goodwill.
Otherwise, increasing the price mid-operation on the surgical table would make him like an unscrupulous clinic, wouldn’t it?
Li Jingsheng wouldn’t sacrifice the important for the trivial for merely a few hundred yuan.
He first performed brachial plexus anesthesia on the young man before starting the skin extraction.
The skin extraction process was without incident.
The difficulty was significant, especially with managing size and shape precisely.
After extracting the skin, Li Jingsheng sutured the graft to the wound area.
Fortunately, he harvested the inner upper arm skin layer, else the green dragon tattoo on his arm would have been a problem.
So, if one isn’t mixed up in society, there’s no need to imitate street bigshots with tattoos.
Many admire left green dragon, right white tiger tattoos, thinking they look powerful, but that’s a childish notion.
If one truly has ability, even looking scholarly, they can hold life and death in their hands.
Without strength, tattoos from head to toe are pointless.
They only foster avoidance, serving no beneficial purpose.
[You successfully grafted skin: Suturing Skill +1, Square Knot +1, Life Points +1000.]
Right after finishing the wound repair for the patient, Li Jingsheng earned his second-ever whopping 1000 life points.
This made him extremely happy.
Finishing the graft wasn’t the end.
There was still a tricky procedure of packing the wound surface with iodoform gauze.
This was another technical task.
Having received 1000 life points and deliberately saved 1672 life points recently, it was ample for him to upgrade his doctor level.
To avoid unnecessary delays, he did not hesitate and immediately spent 2291 life points to upgrade to Associate Chief Physician level.
After upgrading, he unexpectedly felt a bout of dizziness.
This had never happened before.
He silently lamented, realizing he should have waited till after surgery to upgrade.
Thankfully, the dizziness did not last long.
After upgrading, he delightfully noticed a significant increase in his clinical medical thinking and his understanding of pathology, medical science, and pharmacology.
It felt as though he suddenly turned from a poor student into an excellent one.
Before upgrading, he thought being at Attending Level was already very impressive.
But now he realized, there is always a higher mountain.
His understanding of the surgery, specific surgical plans, postoperative outcomes, and risks had all greatly improved.
Upon seeing the patient’s oral wound again, he could even foresee its postoperative appearance.
Within three to seven days post-operation, what risks could emerge?
He could now predict and perceive various minor details in advance.
For instance, damaging the parotid duct during suturing.
Or graft necrosis.
If the graft was too thick, or the wound wasn’t properly hemostatic before transplantation, graft necrosis could occur.
Too thin a graft won’t work either.
Post-healing contraction could result in the patient having difficulty opening his mouth.
The choice of an upper inner arm skin graft, with moderate thickness, luckily helped avoid these risks.
"So this is the capability of an Associate Chief Physician, indeed it is powerful. Even with weaker surgical ability, the diagnostic and understanding of pathology and pharmacology is beyond what Attending Level can compare to."
Li Jingsheng was very satisfied after experiencing the strength of the Associate Chief level.
The experience value needed for an Associate Chief upgrade was 5000, a harrowing number.
Normally, reaching Associate Chief Physician level by thirty-eight is already considered impressive.
Moreover, many young Associate Chief Physicians, although having their titles elevated, still fall short in actual capability.
Li Jingsheng, not even thirty yet, now has a substantial Associate Chief capability.
The Second Hospital extended generous offers to recruit him, initially valuing his Bone Setting talent.
They aimed to develop the Bone Setting department more solidly and significantly.
Now, with his Associate Chief level, he’ll probably soon give Director Hua, Dean Fu, and others a big surprise.
In the upcoming city skills competition, if given the chance, he will shine brilliantly.
Being catapulted to fame was entirely possible.
After wrapping and suturing the iodoform gauze for the patient, this surgery could be considered a complete success.
Just for making that gauze wrap, he earned another 100 life points as a reward.
Nearly all first-time procedures tended to garner high life point rewards.
And of course, nothing felt as gratifying as receiving thank-you banners.
Now with his private consultation room at the Second Hospital, he often receives banners from grateful patients.
The vast majority of patients indeed understand gratitude.
Human beings are not insensate; how could they not feel the doctor’s genuine care for them?
"For the next seven days after the surgery, you should only consume liquid foods occasionally. During this period, you cannot eat solid food."
The patient became anxious after hearing this.
He wanted to speak, but Li Jingsheng gestured for him not to worry.
"Come to the clinic daily over these few days for an infusion, I will give you nutritional injections."
Li Jingsheng quoted two thousand, thinking that it was truly a low price.
The patient’s lesion also needed to be sent off for biopsy!
Added with the skin grafting, charging three thousand yuan wouldn’t be excessive.
Nevermind, this time, he decided to earn a bit less. The skin graft earned him 1000 life points, making it not a total loss.
The patient’s family was in poor financial shape, unable to gather even two thousand yuan, he considered it an act of kindness.
Li Jingsheng escorted the patient out of the surgery room, reiterated the aftercare instructions to the family.
Though seemingly a not too substantial surgery, at a larger hospital, it would be normal to spend seven to eight thousand yuan.
Various examination fees alone would cost a lot.
Here, everything was covered for just two thousand yuan, it was definitely a great deal.
Now, he could only hope that the grafted skin could survive.
For the next three days, Li Jingsheng wouldn’t be at the clinic, so he had to entrust Dr. Shao and Tang Ping with patient supervision.
They needed to closely monitor the patient’s condition.
He prescribed medication for the patient, starting with today’s prescription.
Mainly using antibiotics to control infection, along with nutritional fluids.
He had confidence in his suturing, barring unforeseen circumstances, the patient should be able to consume soft foods in about five days or so.
