Chapter 261 257. Preparations after surgery

Craig was indeed in the most serious condition among these wounded soldiers. He was bleeding heavily from the wound and his mental state was not very good.

Mendelstein has seen too many wounded soldiers like this. Once they do not get help from doctors, they will die after a short time. Therefore, in his eyes, surgery is only to save the person. Whether the leg can be kept, he

There was no hope at all.

Even if they really took Craig back to the temporary rescue center of the military headquarters, their military doctors would do an amputation when they saw this kind of wound. Whether he could survive after the amputation would all depend on his luck.

But when Craig was carried out of the confessional, Mendelstein could clearly see that his right leg had not disappeared, but was paired with his left leg under the blanket.

This sudden surprise left the battle-hardened captain speechless for a moment. Instead, Kawei, who came out with him, stepped forward and spoke first: "Captain, the operation is over. Your soldiers are quite lucky.

At least the leg is saved."

Mendelstein's mind didn't turn around: "What about people? How about other people?"

Kawei was a little confused: "He is a very nice person. His blood pressure and heart rate are normal. Speaking of which, your blood saved him in time, otherwise we don't know what would have happened during the operation."

Mendelstein stepped forward and lifted the blanket, looking at the cleaned thigh covered with a piece of gauze and tape, and fell into deep thought.

He has never seen this kind of surgery. Can such an exaggerated gunshot wound save the thigh?

"Really saved?"

"You also know that his thigh is bleeding badly and all the blood vessels are severed. It is not easy to anastomose these blood vessels. It depends on his subsequent recovery." Kawei explained, "The time will be longer than Lieutenant Opal. If

If nothing happens in the next four or five days, it will be fine."

"Five days." Mendelstein asked, "What if something special happens during these days?"

"If something bad happens and something goes wrong, I can't guarantee it 100%. I can only try to find a way."

"Can you survive?"

Kavi looked at him, and then realized that the captain in front of him was not Ignatz or his assistant. Not only did he know nothing about surgery, he was also very unfamiliar with surgery that abandoned amputation. Kavi gently patted his shoulder.

He smiled and said: "Everyone is fine, the probability of an accident is very low."

"Very good!!!"

From the beginning of the previous blocking battle, Mendelstein was full of guilt for his command errors.

An encounter that should have ended easily ended with the loss of more than 20 men. After the battle, revenge occupied his heart, and it was not until he saw the wheat fields in front of the town of Otaka that he began to doubt his decision.

He was afraid of leading the remaining soldiers into a dead end, and even more afraid of encountering various uncontrollable situations.

When he entered the town, he prepared for the worst. If he really encountered a large number of enemies, he would cut off the rear and let the soldiers take Opal to evacuate first.

Of course, the current results have greatly exceeded Mendelstein's expectations. All the wounded soldiers brought have been treated. As long as the First Army continues to advance the front, they will be able to join their own troops.

Everything is going in the right direction.

"Place the wounded soldiers, and then go to the residences to collect some food. We still need to rest here for a while." Mendelstein gave the order, and then asked, "By the way, how long have the messengers been gone?

?”

"It's been a while, but it takes most of a day to get there and back."

"Now that all the wounded soldiers are safe and sound, we don't have to worry. Just wait for the messenger to pass the news to the military headquarters and inform us of our location. What you have to do now is to stay close to the wounded soldiers and observe their condition. If you find any

If any abnormality occurs, notify the doctor as soon as possible.”

The soldier stood up straight and shouted "Yes", then asked another question: "But Captain, no food was found in the residence."

"No?"

"We started searching as soon as we entered the town. There was indeed none. They must have been taken away, or they ate them all themselves."

Mendelstein pondered for a moment and said, "Then why are you still standing there? If you don't have food, then go look for food in the surrounding woods."

"But we all carry three days' worth of dry food, which is enough."

"We've had enough, but what about them?" Mendelstein pointed at the doctors who had just come out of the operating room and said, "They left all the food in the carriage. Oh, by the way, you take four or five people back to the original place.

place and bring back the food on their carriage."

"yes!"

"If there's not enough food, just look for hares along the way. If that doesn't work, share our dry food with them."

"knew!"

Mendelstein seemed to no longer doubt Kawei's identity and was willing to share dry food, but in Kawei's eyes, they did not turn the corner. The escort just escaped the first wave, and they are likely to encounter more

More trouble.

The escape plan originally considered will definitely not work.

The other party also came on foot, without horses. It would be impossible to deal with them one by one. Their side has been under surveillance, and the number of people is disproportionate. All they can do now is to stand still and say: wait.

But the waiting itself is the most troublesome, and time is not good for the escort team.

The Prussian First Army, which was fighting fiercely with the Austrian army at the front, was superior in terms of strength, morale, and weapons and equipment. Lamin's Sixth Army was bound to be defeated. A person like Kavi, who did not understand military affairs, could see the situation of the battle.

It has been decided that the only thing that can become a suspense is how long they can resist.

If the luck is bad enough, the Sixth Army may be defeated tonight, and then their "neutral" medical team is likely to be invited to Prussia to help. If this is the case, Kawei will not be able to resist. The only advantage is

That is, the escort disguised as civilians can leave safely.

Although Aleister has been monitoring himself, at the same time, he and the members of the escort team are indeed fulfilling their protective duties.

The battlefield was ruthless, and even though Kawei had conflicts with him, deep down in his heart he was still mostly grateful, and this time he was able to return a favor to him.

As for whether Mendelstein really believed him, Kawei couldn't tell. He was not a person who would put his thoughts on his face. Moreover, he couldn't remember whether there was anything with Austrian markings on the carriage.

Okay, I can only take one step at a time.

Fortunately, Prussia in the 19th century was not Germany during World War II. If their identity was really exposed, they should be able to spare the medical team a way out for the sake of the Geneva Convention and the surgery just now.

No matter what the future holds, my life is finally saved.

Kawei followed the soldiers carrying the stretcher, briefly reviewed the current situation, and then focused on Craig again.

The operations on the operating table are only a small part of surgery, and postoperative recovery is the more important link. Although the technology of this blood vessel transplant surgery is innovative enough, it is still much rougher than the regular process.

If not handled properly, the success of the surgery may be wasted.

The problems encountered after autologous vascular transplantation are nothing more than poor backflow, blood clots and infection.

They exist independently, or they can cause and effect each other, forming an endless loop after complementing each other. If you want to break this loop and make Craig fully recover, you need to actively fight against complications.

The first is swelling of the lower limbs, which is the easiest to deal with.

Surgical trauma will inherently cause swelling of limbs, and swollen limbs will compress the lumen of blood vessels, increase resistance to blood flow, slow down blood flow, and increase the chance of blood clots.

At the same time, when the blood flow slows down, blood stasis will form, the tissue will become more swollen, and the compressed cells will gradually become necrotic. The necrotic cells will not be removed immediately. With necrosis + blood, the lower limbs will become a petri dish for bacteria to breed.

Compared with artificial blood vessels, the incidence of lower limb swelling after autologous blood vessel transplantation is not high. However, considering that there is no magnesium sulfate to reduce swelling, the preventive work must be done and there is no room for laziness.

"This private residence is not bad." Kawei glanced at the room and found the hook for hanging the candlestick on the wall. "Don't put him on the bed in a hurry. Move the bed to a different position first."

The two soldiers only listened to the orders of Mendelstein and Opper. Suddenly a young man came and pointed fingers at them. They always felt uncomfortable: "What do you mean?"

"Move the table here and put the bed here." Kawei also saw their thoughts and said, "If you want him to recover, just listen to me. I am a doctor."

The soldiers looked at each other and had no choice but to do as they were told, but Kawi's request didn't stop there: "Take down the curtains on the windows as well."

"What's this for?"

"His leg was seriously injured, and I had to lift his leg." Kawei explained, "Don't waste time, just do as I say."

The soldiers had never seen a doctor who asked for so much, but this guy was the first to save people, and Mendelstein's attitude towards him was second. They couldn't say much: "Okay, you saved Craig, we believe you."

.”

The curtain was taken off, tied in a knot, and hung on the candlestick hook. Craig's head was facing outward, and his calf was suspended on the curtain. The gravity of the blood itself increased the amount of blood returned to the heart and prevented congestion and swelling of the lower limbs.

After the swelling is resolved, the next step is blood clots.

Swelling can form thrombus, and blood vessel suturing itself will make the intima of the blood vessel become uneven, which will increase the incidence of blood clots. In addition, after trauma and surgery, the blood is in a hypercoagulable state, and infection and limb

Due to the double stimulation of swelling, the incidence of thrombosis further increases.

Among the three major complications, thrombosis can account for more than 90%, so "preventing thrombosis" is the most important task, which runs throughout the entire perioperative period.

During the operation, Kawei tried to expand the diameter of the grafted blood vessel as much as possible, but the clinical situation was unpredictable, and any complications that could be called were force majeure. He currently lacks anticoagulants such as heparin in the body, and the two offset each other, which may lead to the formation of thrombosis.

Sex is still very high.

"Let him drink more water after he wakes up." Kawei said, "Our people will come over later to give him fluids, so as to dilute his blood and reduce the viscosity of the blood."

"What should I do if I pee?"

Kawei also thought about inserting a urinary catheter, but just like the incontinence that may occur during anesthesia, the current urinary catheter lacks an inflatable balloon and the opening cannot be fixed in the bladder. At the same time, urinary tract infection was also taken into consideration, so it has been

He ignored them: "I can only rely on you to relieve myself. We have other wounded soldiers and patients to deal with, and we really can't handle them."

"Well, we are comrades after all. As long as he gets better, these are all small things."

The second is infection.

The incidence of infection in modern vascular surgery autologous transplantation is not low. Even with the routine use of antibiotics, it can reach 10-20%. Now there is no carbolic acid, no alcohol, and no methylene blue. The surgery is performed in churches in rural towns in Central Europe.
To be continued...