A Surgeon Who Uses Martial Arts [EN]: Chapter 402

Chapter 78. Return Home (2)

Cheeeee.

Low-pressure saline solution sprayed from the metal hose.

The saline solution washed away the hardened blood clots, bone fragments, and various foreign substances.

While Devin was cleaning the severed wound.

Jun-hoo was staring intently at the patient’s mangled leg.

He had seen enough of it in the emergency room, and even more gruesome scenes in the Murim world [a world of martial arts and cultivation, often depicted in Asian fantasy novels], but.

He couldn’t help but frown.

The amputation line from the chainsaw was an uneven diagonal.

The wound started from the side of the calf and ended just above the ankle.

The depth of the wound was also significant.

The saw blade had penetrated about two-thirds of the way into the leg.

It looked as if the leg would break off with the slightest impact.

Fortunately, the wound had narrowly avoided the major arteries.

Jun-hoo was taken aback because he had never seen such a case during his hand surgery training or in hand surgery papers.

All sorts of thoughts crossed his mind.

Did the patient harm himself?

Or was the patient a member of a criminal organization who was punished for displeasing his superiors?

He even had such thoughts for a moment.

But the final diagnosis was ‘accident’.

There was not much evidence to suggest that the wound was artificially created.

The patient’s desire to get his leg back.

The wood fragments on the clothes he wore to the emergency room. (The patient said he was injured while woodworking.)

The somewhat crude-looking wound, and so on.

Jun-hoo imagined the patient getting injured in his head.

The patient is using a chainsaw while holding a wooden plywood in place with his foot.

Then, whether he was distracted or lacked strength, the chainsaw slipped from his hand.

The saw blade begins to cut off his leg.

The terrifying saw blade cuts through the leg in an instant, and the pain comes belatedly.

A scream erupts belatedly.

The patient hurriedly throws the chainsaw and collapses to the floor.

“Jun-hoo, the irrigation is finished.”

At Devin’s words, Jun-hoo snapped back to reality.

It wasn’t perfect, but most of the contaminants had been washed away.

The kidney dish [a shallow, kidney-shaped basin used in medical settings] placed under the patient’s leg was full of dirty saline solution.

The resident removed the kidney dish.

“Are we going with type A? Or type B?”

“Type A would be better.”

“Wouldn’t type B be better? I think it would be better to start from scratch?”

Devin insisted on type B.

There were two ways to operate on a patient whose wound was on the verge of amputation.

First, type A.

This was a method of performing surgery while preserving the remaining tissue.

Type B was a method in which the remaining tissue was also amputated, and then the surgeon reattached the wound from scratch.

“With this level, we can remove only some contaminated areas with debridement [the removal of damaged tissue or foreign objects from a wound] and restore it. There’s no need to amputate.”

“Are you sure it’s okay? I think it looks unstable.”

“In what way?”

“A considerable amount of area will be lost due to debridement. Considering the area, reconstruction will not be easy either.”

Devin did not easily change his mind.

Of course, Jun-hoo didn’t think his opinion was wrong either.

Devin’s opinion was textbook.

It means it’s safe.

But a surgeon should not only pursue safety.

He also had to be able to make bold decisions for the patient’s life or quality of life.

“Even if it’s cumbersome, preserving body tissue is better for the prognosis.”

“Ha… Jun-hoo always chooses the difficult path. Are you the type to buy hardship?”

Devin asked, clicking his tongue.

“I hear that story so much that I’m sick of it. But what can I do? My personality is originally impulsive.”

“Okay. Do whatever you want to do.”

The nuance in Devin’s words was subtle.

‘I believe in you.’

‘I gave up on you.’

Depending on the point of view, it could be interpreted in both ways.

Considering the attitude he had shown so far, the latter was highly likely.

However, Jun-hoo thought the latter wasn’t bad either. There would be no more arguing about everything.

‘Ultimately, when I do the surgery, he will have no choice but to believe in me.’

Technically.

Psychologically.

Jun-hoo was on top of Devin.

And only Devin was unaware of the gap.

“Adhesive.”

At Jun-hoo’s order, the resident handed over the adhesive and a spatula-like surgical tool at the same time.

Jun-hoo spread the adhesive on the medical spatula and applied it evenly to the patient’s fractured bone.

“Wire.”

Then, he used wire to wrap around the patient’s bone frame.

It was a work to fix the bone.

Usually, when it comes to anastomosis surgery [surgical connection between two structures], many people think that it starts from the smallest parts and proceeds in the order of large structures, but in fact, it was the opposite.

The first step in the surgery was bone fixation.

Jun-hoo wrapped the bone frame three times with wire and then fixed it.

He tapped the bone with forceps.

The joint surface trembled slightly.

The axes of the upper and lower bones were subtly misaligned.

‘Is it because of the saw blade?’

The wound is uneven and irregular, so it doesn’t fit well.

‘I can force it to fit, but the patient may have aftereffects when he starts moving later.’

Jun-hoo’s eyes narrowed as he looked down at the bone.

Deep wrinkles appeared on his forehead.

He didn’t expect to hit a wall when he started the surgery.

Jun-hoo raised his head and suddenly met Devin’s eyes.

Devin was saying with his eyes instead of his mouth.

‘That’s why I told you to do amputation surgery instead of anastomosis surgery.’

“Please bring me a metal plate, screws, and a drill.”

“What are you going to use that for?”

“It will be faster to see than to hear.”

At Jun-hoo’s order, the resident tilted his head and moved to the warehouse.

Devin and the scrub nurse also had expressions of not knowing what Jun-hoo’s sudden action meant.

After a while, the surgery resumed.

Jiiiiing.

The loud drill sound spread throughout the operating room.

Every time the drill penetrated the tibia [shinbone], bone fragments scattered like slush.

Jun-hoo drilled three holes each above and below the patient’s severed wound.

He put a metal plate on top of it and screwed in medical screws.

He touched the bone again.

The bone was firmly fixed like the roots of a thousand-year-old pine tree.

A smile spread across Jun-hoo’s lips.

* * *

“Is this okay?”

Devin asked with surprised owl eyes after the procedure was over.

“I’ve never heard of doing metal plate fixation on anastomosis surgery?”

“Of course not. Because I’m doing it for the first time.”

“Cough. Cough.”

Devin ended up coughing from choking.

He couldn’t even count the number of times his heart had sunk because of Jun-hoo today.

‘I was going to stay still if possible, but this is too much.’

A fire soared in Devin’s chest.

“What are you going to do if you use a metal plate because the bone is not fixed?”

Devin began to argue, raising the veins in his neck.

The atmosphere in the operating room rapidly froze. The resident and scrub nurse didn’t know what to do.

The only person who was shamelessly calm was Jun-hoo, who had caused a major accident.

“Surgeons don’t use wire for no reason. This will stiffen the patient’s leg.”

“…….”

“If he can’t walk properly, what’s the difference between wearing a prosthetic leg and the patient’s leg?”

“The metal plate can be removed after 6 months. He’s not going to wear it for the rest of his life.”

“Are you telling the patient to have another surgery?”

“It’s a hundred times better than wearing a prosthetic leg.”

Jun-hoo continued in a cold voice.

“Hey. Devin.”

“What is it?”

“Have you ever performed spinal fusion surgery?”

Devin shook his head.

Of course, that would never happen.

Devin majored in hand surgery, not cervical and lumbar spine [the neck and lower back].

But he seemed to know vaguely what Jun-hoo was trying to say.

“Have you ever seen a patient who couldn’t move his waist because his lumbar joint was stiffened after receiving spinal fusion surgery?”

“Ah… No.”

Devin stuttered, cornered.

He was gradually getting caught up in Jun-hoo’s logic.

Fine hairs stood up on his arms.

The back of his neck felt chilly.

“Then isn’t it the same for the patient we’re operating on?”

“But I’ve never done metal plate fixation on anastomosis surgery. What are we going to do if we suddenly do a surgery that hasn’t been verified?”

Devin barely retorted.

“Don’t you know why that happened?”

“Yes. I don’t know. Jun-hoo, do you know?”

“Of course I know.”

Jun-hoo nodded confidently.

“What’s the reason? Why don’t you use metal plate fixation in anastomosis surgery?”

“That’s… I’m not going to tell you.”

Jun-hoo’s voice was annoying.

Ugh, I’m so angry!

* * *

“2-0 PDS (absorbable synthetic thread) [a type of suture material].”

Jun-hoo fixed the suture handed over by the resident with a needle holder.

He performed sutures to connect the muscles and bones.

The tendons that the saw blade had passed through were jagged and scattered. But Jun-hoo skillfully sutured the tendons.

The suture that Jun-hoo used when performing the Siamese twins separation surgery was 11-0.

It was several times thinner than a hair.

Compared to that, the 2-0 suture was like a shoelace.

He couldn’t make a mistake even if he wanted to.

“The reason why hand surgeons don’t do metal plate fixation is… the reason is simple.”

Jun-hoo showed the 余裕 [room to spare/composure] to talk while suturing.

“That’s it. I’m not curious at all anymore.”

Devin retorted in a sulky tone.

“Close your ears if you don’t want to hear it.”

“…….”

“The reason is that hand surgeons don’t have experience in spinal and cervical spine surgery. That’s the true value of the boost-up program.”

Jun-hoo’s explanation continued.

In the boost-up program, trainees learned all the sub-specialties handled in neurosurgery.

And this fostered a hybrid way of thinking.

To put it in terms of cooking, would it be like becoming a fusion chef?

Incorporating Western food into Korean food.

Like incorporating Chinese food into Korean food.

The same was true of Jun-hoo’s use of metal plate fixation in this anastomosis surgery.

He used the knowledge he learned in the spinal and cervical spine part in anastomosis surgery.

As he learned various majors evenly, the horizon of thinking about surgery was widened.

This was an unexpected gain for Jun-hoo as well.

He wasn’t expecting his thinking to be broadened in the boost-up program.

“Are you still not convinced by metal plate fixation?”

“No. Thinking about it, it seems okay.”

Devin continued in a sighing voice.

“I lost. I surrender. Jun-hoo is much better than me. I think I know why the director praised you.”

Devin’s attitude changed 180 degrees.

‘I believe in you.’

‘I gave up on you.’

He chose the latter and returned to the former.

The only reason was that Jun-hoo was not just a surgeon who was good at talking, but also a surgeon whose hands were alive.

Even if they cursed Jun-hoo outside the operating room.

No one could curse Jun-hoo inside the operating room.

The seven master badges on Jun-hoo’s doctor’s gown were proof of that.

About 5 minutes passed.

The first suture was successfully completed.

It was a smooth suture without crisis and climax.

“I’m going to do the Krackow suture [a type of suture technique] to connect the gastrocnemius muscle [calf muscle] and the tibia.”

“You know how to do the Krackow suture too?”

Devin asked with wide eyes.

Jun-hoo replaced the answer with a smile.