Chapter 118: Suturing the Wound

Jiaoyan held the scalpel and tissue forceps, carefully excising and separating the necrotic tissue from the wounds. She then turned back to the box, selecting the appropriate needles and sutures.

The wounds on these men were quite deep, but given the limited supplies available to her and her master, multi-layered suturing was out of the question; they would have to settle for a single-layer closure. Assessing the size and depth of the injuries, Jiaoyan chose the suitable sutures and matching needles.

After soaking the suture thread in a bottle of strong spirits, she used tweezers to pick it up and threaded it through the needle held by the needle holder in her other hand.

There were over a dozen grown men present, none of whom had ever witnessed such a scene. They had no idea what Jiaoyan was doing. The man who had spoken earlier could no longer contain himself. "What are you doing?" he demanded. "What are you doing with all these strange gadgets? And why are you bringing out needles? These are human beings, not pieces of cloth! Why are you playing with women’s sewing tools?"

Jiaoyan glared at him, her frustration mounting. "If you keep blathering, get out! Do you want him to live or not? With wounds this deep, what happens if they tear open while healing? Suturing them ensures they heal properly. If you don’t understand, just stand aside and watch. If you say one more word, Brother Axi, throw him out!"

The dozen or so men were stunned. They could never have imagined that such a tiny young girl could possess such an imposing air when she hardened her expression. The way she carried herself suggested that if they dared to speak again, she truly would have Axi toss them out.

Though it was hardly the time for amusement, Axi couldn't help but want to laugh at the sight of Jiaoyan. He tried his best to suppress it, his face turning bright red, but he managed to hold it in. Their young mistress was not to be trifled with; she had been difficult enough before, and now that she had learned medicine, she was even more formidable.

Seeing that everyone had quieted down, Jiaoyan turned her attention back to the work, satisfied. The anesthetic had taken effect, and the man was now in a deep sleep. Jiaoyan gripped the needle holder and began to stitch the wound.

Suturing an external wound is by no means a simple task. It is not like sewing clothes; it is a matter of how well the wound will heal. One must be precise with the depth of the stitches—go too deep, and you catch healthy flesh, causing the skin to invert. Go too shallow, and you leave "dead space" in the deeper layers, which can delay healing, invite infection, and cause the wound to fester.

Furthermore, the tension on both sides of the wound must be uniform, and the angle of the needle must be symmetrical. Otherwise, the skin will not align properly, which is detrimental to healing and results in prominent, ugly scarring. Each layer of tissue must be aligned tightly and accurately, a task that requires true experience.

For Jiaoyan, however, these were not issues. Although six years had passed, the moment she picked up these surgical instruments, all her old instincts returned. She handled the tools with practiced ease, stitching the wound with precision.

There are many methods of suturing: interrupted, continuous, continuous interlocking, and purse-string sutures, among others. Given the length of the man's wound, Jiaoyan chose a continuous interlocking suture. She worked with incredible proficiency, the distance between each stitch as perfectly uniform as if measured by a ruler.

In trauma suturing, the density of the stitches is also critical. Too dense is unnecessary, while too sparse fails to close the wound. The standard requirement is that no arc-like gaps remain between stitches.

The tension of the stitches must also be carefully managed. The goal is to bring the wound edges tightly together without cutting through the tissue or causing ischemic necrosis from being tied too tightly; the tension must be just right.

These requirements posed no challenge to Jiaoyan. Before long, she had finished the first wound. The skin surface along the suture line was slightly raised, with no signs of depression or curling. Jiaoyan examined her work with satisfaction; despite the years of inactivity, her skills had not faded.

She tied off the final knot and snipped the thread with her scissors.

There were three wounds on the man that required stitching, so Jiaoyan continued to work with focus. Fortunately, she was fast, and it did not take long to complete all of them.

Nearby, Miao Suwen was also suturing, but her speed was clearly not as fast as Jiaoyan’s; she had just finished the first wound. Without a word, Jiaoyan moved to the second man. Ruyun and Ruyue had already performed a basic cleaning of the wounds, so after washing her hands, Jiaoyan performed a deep cleaning and proceeded to suture the second patient just as she had the first.

Jiaoyan’s hands were swift; by the time she finished the second man, Miao Suwen had only just finished her first. Miao Suwen moved to begin on the last patient, but Jiaoyan stopped her. "Master, you go ahead and write the prescriptions. Also, explain the wound care clearly to them; I’ll be done here in a moment. Otherwise, when the anesthesia wears off, they’ll suffer for no reason."

Miao Suwen did as she was told. She carefully inspected the wounds Jiaoyan had sutured and found them far superior to her own. She was secretly astonished—looking at Jiaoyan’s practiced movements, she didn't seem like someone who had just encountered these tools for the first time.

Recalling the suggestion to suture the wounds and the design of the tools, Miao Suwen felt as though Jiaoyan had known these things all along. But that didn't make sense—how old was Jiaoyan? How could a six-year-old girl know such things?

Though filled with doubt, Miao Suwen remained focused on the task at hand. She pushed her questions aside, found clean gauze, and carefully bandaged the wounds. She then took paper and a brush to write out the prescriptions, instructing the men on how to take the medicine and how to maintain the cleanliness of the wounds.

Once Miao Suwen finished her instructions, she went inside to prepare the medicine. Jiaoyan also finished suturing the last man, applied medicine to the wounds, and bandaged them. After all, Jiaoyan was only six, and the intense concentration and physical effort left her covered in sweat.

Ruyun brought a cloth to wipe the sweat from Jiaoyan’s face. "Little Mistress, rest for a moment."

Jiaoyan looked at the dozen men, who were now staring at her with expressions of profound awe. She glared at them and said, "Well? Are you waiting for me to feed you lunch, or are you going to carry these people out?"

The men quickly stepped forward to express their gratitude. "Thank you, Physician Miao! Thank you, little girl!" the man who had spoken first said, bowing deeply. "What is the fee for the treatment?"

"For the fees, talk to my master. Leave the addresses for these men; they will need their dressings changed every day. In seven days, the stitches will need to be removed. I will come to you then, so you won't have to make the trip back and forth. Remember, keep the wounds clean. If there is any sign of fever, bring them to my master immediately." Jiaoyan waved her hand and went to find a seat to rest.

At that moment, Miao Suwen emerged with four bundles of medicine. The leader of the group hurried over to settle the bill with her. Miao Suwen handed him some medicinal ointment as well. The other men also had minor injuries; they weren't life-threatening, but as a healer, she couldn't bear to see people in pain, so she gave them ointment to apply themselves.

The men thanked Miao Suwen and Jiaoyan profusely, almost to the point of kneeling. Miao Suwen waved them off, urging them to take the injured home to recover. "They are still under the effect of the anesthesia, but once it wears off, the wounds will be painful. I’ve given you some pills; if the pain becomes unbearable, have them take one. Do not give them more, as too much is not good."

"Care for the injured, give them nourishing food, but keep them away from spicy or irritating foods. In a few days, when the wounds begin to heal, give them richer food to help them recover, as they have lost quite a bit of blood."

The men listened intently, nodding repeatedly, before thanking Miao Suwen once more and leaving their addresses. Finally, they carried their companions away from the Miao household.

Axi and Alu, however, did not leave, choosing to stay behind.

Jiaoyan looked at them and asked, "Brother Axi, what happened today?"

Axi sighed and recounted the events. He worked as a laborer on the docks of Shao Kou Town, loading and unloading cargo ships. The river outside the town was a vital transport route connecting the Northeast to the sea, and with two rivers converging there, there was a great deal of shipping traffic. Axi and the other porters could earn a decent wage every day.

Where there are people, there is conflict, especially at a bustling dock with so much money to be made. There were factions there, and today two of them had fought over territory. He hadn't expected the other side to be so prepared, bringing blades and swords, which had caused them to suffer heavy losses. Of course, the other side hadn't come out unscathed either, suffering their own significant casualties.

Jiaoyan was deeply worried. "Brother Axi, Brother Alu, if it's like this, maybe you should stop working at the docks. It’s too dangerous. Find something else to do—it might pay less, but at least it’s safe."