Chapter 44 - Absorbable suture

Chapter 44: Absorbable suture
Translator: 
EndlessFantasy Translation 
 Editor: 
EndlessFantasy Translation
Wee woo… Wee woo…
When the ambulance’s siren rang, Juan Zi first pushed the wheelchair to the door and prepared to receive the patient.
This was the third batch of patients sent by Lu Jinling, and the patients from the previous batch were still in the middle of receiving fluid transfusion.
Ling Ran stretched lazily and also prepared to receive the incoming ambulance.
He was not displeased in the least about performing sutures on his rest days. If he could monotonously tie knots tens of thousands of times just for training in medical school, he could definitely do boring debridement and suturing tens of thousands of times as an intern as well.
The study of medicine was always a kind of skill set that had to be practiced often in order to be perfected. Theory was indeed important but the value of experience could not be ignored.
For Ling Ran, playing games was a way to relax, and doing debridement as well as suturing was also considered a form of relaxation. The fun in both varied. It depended if the game started off smoothly or if the patient who required suturing had an interesting case.

His glutes has been stabbed. The wound is rather deep…


The back injury isn’t too serious. Lie down here for debridement.


The foot injury is infected. Doctor Xiong, please come over and carry out the debridement.

Ling Ran did not immediately carry out first aid on whichever patient he could lay his hands on. Instead, he acted like he was in a resuscitation room. He looked and diagnosed each patient one by one and classified them respectively.
This was also a new thing he learned after he started his internship.
Even in the Emergency Department of Yun Hua Hospital, diagnosing a patient had to be done quickly. It was common for an ambulance to send four or five patients in one go, yet there were not many available doctors. The order of diagnosis and treatment naturally could not be based on a first come first serve basis. It was carried out according to the severity of the patient’s condition.
After two rounds of coordinating with Ling Ran, Doctor Xiong and Juan Zi gradually became familiar with Ling Ran’s rhythm. Additionally, working with them made Ling Ran feel more at ease than working in Yun Hua Hospital.
No matter how skilful the doctors were in Yun Hua Hospital’s Emergency Department, they could not properly assist him. At most, they would help him a little. Over here, Doctor Xiong and Juan Zi made serious efforts in cooperating with him, and the effects of their treatment were much better.
During suturing, he only needed to pierce the needle through the patients’ skin. The threading and knotting work could be done by Doctor Xiong, making work much easier for Ling Ran.
In the hospital, ordinary Level 2 surgery had the same configuration.

Alright. The three patients are done with their stitches. There’s only one last patient left. How are you planning to stitch her wound?
Doctor Xiong bandaged the last patient. He said to Ling Ran while feeling somewhat worried,
Girls are sensitive about their beauty, and she’s wounded at the shoulder. If it’s not easy to stitch, let’s send her to the hospital instead.

After that, with a considerable amount of curiosity, Doctor Xiong asked,
Little Lu, where did you manage to get all these patients from? You even found a woman who’s been in a fight?


She was drunk in a KTV.
Lu Jinling kept her gaze forward. It was unclear if she was looking at the patient or Ling Ran. Her answer was simple and short.
Doctor Xiong was enlightened, but shook his head in confusion the next instant.
Drinking at a KTV at this hour…?


Afternoon sessions in the KTV are cheap now. Many people would go for some barbeque at night once they’ve had enough drinking and singing. Helps them save money.
Lu Jinling disclosed.
The patient was a girl of indiscernible age, and her face was covered in heavy makeup. As she gradually sobered up, she looked at her wound and asked,
Can you stitch it up? How much longer will it take?


Ten minutes,
Ling Ran looked down at the wound and said. Then, he asked Juan Zi,
Give me a 5-0 thread. Do we have catgut?


Wait a minute.
Doctor Xiong quickly interrupted Ling Ran.
It’s expensive to stitch this wound with absorbable thread.


What should we use otherwise?
Ling Ran’s judgment was very simple. For the scar to be aesthetically pleasing and less visible, using thin thread and absorbable sutures was the way to go.
Doctor Xiong had been around the clinic for a long time, so he considered more aspects. He pulled Ling Ran a few meters away and asked,
Have you thought about this thoroughly? Can you stitch it?


Yes.
Ling Ran’s answer was short and confident.
He was already a master in suturing. If he could not even manage such a simple wound, it would just be embarrassing for him.
Doctor Xiong nodded, feeling somewhat skeptical. He said,
The absorbable thread will leave a shallow scar. If you can stitch it well, we can really make some money in this small clinic. However, the 5-0 thread will be too thin. Shouldn’t we use a #0 thread instead?

The diameter of the 5-0 thread was 0.1 millimeter, which was the thickness of two or three strands of hair. The #0 thread was 4-0, which was one and a half times thicker than the 5-0 thread, plus it was less prone to tearing.
From Doctor Xiong’s perspective, Ling Ran would have an easier time controlling a thicker thread. If he switched threads halfway, things would just backfire on him.
Ling Ran calmly said,
Either one will do, but the effect will be better with the 5-0 thread.

For him, any type of thread could be used to ensure a smaller scar, but since he had no idea how much a patient would move about, a slightly thicker thread would also be good to ensure the results of the suture.
Of course, the thickness of the thread mentioned here was relative. The #0 thread was the thinnest and most common thread used in the resuscitation room. Generally, doctors found it inconvenient and would not choose it.
Doctor Xiong looked at Ling Ran, but still felt somewhat uncertain. After a few seconds, he yelled,
Old Ling.

Ling Jiezhou was drinking tea with his wife on the first floor. After hearing Doctor Xiong’s call, he put down his teacup, ran down, and asked,
Is it time to collect the fees?


Almost. Young Ran is preparing to use an absorbable thread to stitch up the patient’s wound. Do tell the patient that absorbable threads are charged based on centimeters in other clinics and hospitals,
Doctor Xiong said.

I see, absorbable threads, right? Some private hospitals are really black holes for money in this regard,
Ling Jiezhou said as he entered the treatment room and cordially consoled the patient for the money she was about to lose while he negotiated with her.
After a while, Ling Jiezhou came out and said,
It’s done. We’ll charge her the price of 1.5 inch absorbable thread for that 1.5 inch wound of hers. Let’s give her a 50% discount. Son, stitch her up well. At least you didn’t waste your years of studying.

The patient in the treatment room was completely awake and conscious at this time. When she saw Ling Ran, she became more nervous. She asked,
You know how to stitch with absorbable threads, right? My shoulders are often exposed to the public. I can’t afford to leave any scars on it.

Juan Zi dragged her heavy legs and brought over the 4-0 and 5-0 surgical catgut.
Ling Ran then placed them in front of the patient and explained,
These two threads won’t leave scars on you easily. The 5-0 thread is a little finer, and the scars will be less visible, but you’ll need to pay more attention to how you move because it may affect the wound—


I’ll go for the finer one,
the patient made a choice without waiting for Ling Ran to finish his sentence.
Doctor Xiong pouted and said,
They’re both very fine.


I want the finer thread.
The patient was very firm with her decision.
Ling Ran was the type who did not like to talk after he finished his explanations. He waved his hand to signal all the people sans himself and the patient to step back as he tore open the suture kit himself.
Threads below #0 were basically attached together with the pinhead. Its characteristic was that there was no eye of the needle at the end of the needle, and the thread was directly pushed into the end of the needle while it was manufactured so that damage to the skin could be minimized during sutures.
During packaging, an ordinary suture kit could be loaded with bundles of five or ten needles, and the ones with pinheads would need to be individually packed, making it very obvious that it was a standard above the other needles.
However, doctors did not necessarily like finer threads. If suturing was regarded as an examination, using thread #7 was equivalent to lowering the passing mark to 30%, and you could pass the exam easily. Using #0 threads were equivalent to pushing the passing marks up to 60%, and the test would have to be done a little more seriously. The 5-0 thread was equivalent to pushing the passing mark up to 80%. Some doctors had to have full concentration while performing the stitches to be able to pass, while some doctors failed even if they tried their best.
Of course, there were always people who scored 100 marks in whatever paper they took.
Ling Ran was an example. Since he obtained Master Level in Simple Interrupted Sutures, forget using 5-0 or 6-0 threads, he could still perform sutures easily even if someone gave him a 10-0 thread.

Okay, you may open your eyes now. Do not let your wound come into contact with water. Try to keep activity to a minimum…
Ling Ran habitually recited the Standard Precaution for Patients. He felt that there was no difference in stitching the patient’s shoulder wound compared to other people’s wounds.
Doctor Xiong who was working as an assistant saw everything with his own eyes, and he felt that Ling Ran had performed the stitches effortlessly. Ling Ran had not been bothered by the thickness or thinness of the thread at all. Doctor Xiong was amazed and tried hard to suppress the shock on his face.
On the other hand, the patient seemed unaccustomed to Ling Ran’s casual attitude. She spoke in a nervous and somewhat uneasy tone,
We’ve agreed that if I scar, you will not only give me a refund, but you will also have to pay me back another sum. If the scar doesn’t stay, I’ll introduce my sisters to your clinic if any of them are injured again.

Ling Jiezhou readily agreed. He did not possess any medical skills, but he knew many doctors, and in his opinion, Ling Ran’s skill was no worse than those doctors who had high market value.
Once he thought of this, Ling Jiezhou thought to himself again. With the current flow of patients, the clinic could hire another part-time doctor. Then, when Ling Ran was on duty in Yun Hua Hospital, the clinic could still operate as usual.
He looked at the utility room next to the treatment room and revealed his signature honest and boyish smile.