Chapter 28: Manual Hemostasis Once More

Page 1 of 3

At that very moment, a large amount of blood had already accumulated in the patient’s abdominal cavity.

Before Cao Chong could even say a word, Fang Zhiyan beside him had already taken up the suction device and begun clearing away the pooled blood and clots.

Cao Chong glanced at him in surprise.

For a moment, he even had the illusion that Fang Zhiyan was more familiar with the operation than he was—perhaps even capable of performing it more perfectly.

But how was that possible?

The boy was still so young. Could he really possess such skill?

It was utterly absurd!

Fang Zhiyan said nothing. He simply carried out the task before him.

Removing the blood was only one part of the procedure. At the same time, they had to examine the site and extent of the liver injury.

Cao Chong swept his gaze across the field, his expression tightening slightly.

“This is bad. The splenic rupture is extensive, and the blood loss is too great.”

Fang Zhiyan quickly assessed the precise condition of the patient’s spleen as well. Using the suction device, he removed roughly one thousand milliliters of unclotted blood.

At the same time, the anesthesiologist, who had been watching the monitor, suddenly rose to his feet.

“Dr. Cao, this is bad. The patient’s blood pressure is starting to fall.”

Cao Chong nodded without panic and issued his instructions in an orderly manner.

“Begin transfusion.”

“Give large-volume fluid replacement. Start with crystalloids, then alternate with colloids. Once urine output is adequate, supplement potassium.”

“Zhiyan, keep a close eye on things.”

“Understood!” Fang Zhiyan nodded, his expression equally grave.

Although he had been a master surgeon in his previous life, that did not mean he could save every patient.

Faced with such a dangerous situation, all Fang Zhiyan could do was draw upon everything he knew and calmly perform his own duties to the best of his ability.

He gripped the suction device tightly, carefully searching for the source of the bleeding.

“We can’t stabilize the blood pressure!” the anesthesiologist called from the side.

A sheen of cold sweat appeared on Cao Chong’s forehead.

He stared intently at the surgical field. Since he had not been able to locate the ruptured tissue in the short time available, they would have to approach the problem from another angle.

He made his decision immediately.

“Zhiyan, find the bleeding point. I’ll clamp the artery and the portal vein.”

During acute massive hemorrhage, the only option was to temporarily cut off the blood supply.

Only then could they buy enough time for the procedures that followed.

Under Cao Chong’s direction, the supplying artery was soon clamped, and the bleeding temporarily stopped.

“It’s working!” the anesthesiologist shouted.

Cao Chong nodded, then turned toward Fang Zhiyan.

“You take over for me.”

“Do you know what to do?”

“Release the clamp every fifteen minutes. Restore the blood supply for a while, then clamp it again,” Fang Zhiyan replied quickly.

Page 1 of 3

Page 2 of 3

Cao Chong felt a surge of relief upon hearing this.

At such a frantic moment, Fang Zhiyan had understood his intentions perfectly, giving Cao Chong considerable confidence.

He handed the position over to Fang Zhiyan and began examining every part of the spleen, searching for the bleeding point.

Once they found it, they would also have to remove the necrotic splenic tissue, debride the wound, and establish drainage. It was an extremely complicated situation.

“I found it. We’ll begin repairing the splenic rupture.”

Cao Chong spoke briefly and began the next stage of the procedure.

Fang Zhiyan quietly continued performing his own task.

At this point in the operation, what mattered most was calmness, patience, and methodical cooperation.

As long as everyone did what they were supposed to do, the operation could be completed successfully.

“Watch the blood pressure.”

“I’m about to begin suturing. The patient’s blood pressure may drop.”

Cao Chong gave a brief explanation before continuing.

The instruments beside the operating table sounded intermittently, keeping everyone’s nerves taut.

At the side, Fang Zhiyan alternated between controlling the bleeding and suctioning away pooled blood, keeping the surgical field clear.

“Number seven suture.”

Cao Chong spoke up.

The scrub nurse quickly handed him the number seven suture.

As he continued stitching, Cao Chong glanced at Fang Zhiyan and casually asked, “Do you know why we’re using a number seven suture?”

Fang Zhiyan nodded.

“With an injury of this extent, a number seven suture allows us to perform interrupted suturing.”

“Mm.”

Cao Chong nodded in satisfaction.

Someone like Fang Zhiyan was truly exceptionally intelligent.

He barely needed to say anything. A casual hint was enough for Fang Zhiyan to understand exactly what he meant.

A student like this was genuinely gratifying to teach.

Cao Chong’s hands never slowed.

Normally, once they had reached this stage, there should not have been any major problems left.

But at that moment, the anesthesiologist suddenly cried out, “What’s happening? Why has the patient’s blood pressure dropped again?”

The moment he spoke, everyone turned toward the cardiac monitor.

The patient’s blood pressure had indeed fallen. The sight made them all frown.

Fang Zhiyan immediately said, “It isn’t a problem on my end.”

Cao Chong instinctively glanced over. Fang Zhiyan was clearly holding the clamp in place, and there was no problem there.

Then why was the blood pressure falling?

“Continue fluid replacement. Keep it stable!” Cao Chong ordered.

The anesthesiologist nodded. “Already doing it.”

“Run a blood-gas analysis.”

Page 2 of 3

Page 3 of 3

The anesthesiologist beside him did not hesitate. He soon placed the blood-gas analysis results in front of Cao Chong.

There was nothing wrong.

Then where exactly was the problem?

Everyone wore a grave expression, unable to reach a conclusion.

At that very moment, something seemed to stir faintly in Fang Zhiyan’s mind.

“Could there be more than one bleeding point?”

“Could the area above the clamp be bleeding as well?”

With that thought, Fang Zhiyan slowly extended his hand.

He possessed perfect mastery of manual hemostasis—a technique that seemed unbelievable to others.

For Fang Zhiyan, however, it often produced miraculous results.

He traced the hepatic artery above the clamp with his fingers, then gently pinched it.

The next instant, the patient’s blood pressure shot up.

Everything happened so quickly that it almost seemed like an illusion.

Cao Chong’s expression tightened again. He swiftly turned toward the surgical field, and finally his gaze settled on Fang Zhiyan’s hand.

Fang Zhiyan’s hand was pressing against the artery.

That very action was what had caused the blood pressure to rise.

Cao Chong took one look and was completely stunned.

“What?”

“Huh?”

The anesthesiologist beside him was equally bewildered.

“Is that right? Is this actually correct?”

An intern was controlling the bleeding with his bare hand?

Had he gone insane?

And yet, it was actually working!

Cao Chong’s face was filled with disbelief.

He suddenly remembered that before Fang Zhiyan had officially joined the hospital, Director He had seemed to mention that the young man knew how to control bleeding manually.

He never would have expected Fang Zhiyan to demonstrate it right in front of him.

“Don’t move. Keep holding it. I’m going to repair the spleen,” Cao Chong hurriedly said.

Fang Zhiyan nodded without a word.

The two of them worked together like that—one repairing the spleen, the other controlling the bleeding.

Maintaining that position for a long time was exhausting.

But they were in an operating room, fighting to save a human life.

What did exhaustion matter?