Doctor's Life Simulator

Chapter 143 Admiration, Director Xie, why did you come up with such a genius plan? (seeking subscription)

The three directors came to the conference room. Since Tian Hua's sister Hua Assistant was not there, no assistant was arranged for a while, so this consultation was all done by Tian Hua.

"The two directors have already buried the affected hand in the bag-shaped flap of the abdominal wall. As long as the plan is determined, it can be peeled off, leaving a thin layer of granulation tissue to cover the wound. But the choice of flap repair has always been thought not good."

Tian Hua thought for a while, since Qin Lang still had a plan in mind, he took out his original plan first, and used it as the basis for discussion, so as to attract others.

"Director Xie, Director Shen, according to the conventional treatment of hand avulsion injuries, I have imagined a plan before, that is to take a medium-thick skin slice from the patient's thigh, insert it into the root of the finger, cover the wound on the palm and back of the hand, and repair Finger webs. Drainage through multiple small incisions in the graft."

"Then, the finger wound is covered in a spiral shape with strip skin flaps, and a large amount of rags are used to compress and bandage."

After Tian Hua proposed his regular plan, Xie Yuhua and Shen Jiachen both nodded slightly. This plan can only be said to be unsatisfactory:

"Director Tian, ​​your plan can be said to be a very mature and safe repair plan. It uses medium-thick thigh skin grafts and strip-shaped skin flaps for spiral coverage. It can guarantee both technically and later recovery. At least sixty points. If it is an ordinary patient, I have no objection, but after all, the patient's family members and patients have higher requirements, especially in terms of later function and aesthetics. This plan is still not good enough."

Of course, Tian Hua also understands the problems of this plan, which is the basis for discussion.

Shen Jiachen followed Tian Hua's train of thought and put forward some of his opinions:
"I think the selection of the flap donor site for this operation can be further discussed. From the thickness of the hand tissue, the nerve division, and the reconstruction of the fingertips and fingers, I think the most ideal location should be foot donor area."

After all, Shen Jiachen is also a senior expert in the industry, and soon thought of several optional donor areas for the feet:
"The flap of the dorsum of the foot, or the flap of the nail of the toe, has the tissue characteristics and thickness very similar to that of the hand."

Tian Hua and Xie Yuhua also agreed, but they both raised a question:
"The skin flaps of these two donor areas are indeed very suitable for the repair of the hand in terms of tissue characteristic neurovascular distribution. However, don't forget that the patient's hand is too traumatized. It is difficult to choose a flap that can cover the affected area. Flap."

Shen Jiachen also agreed, which is why Tian Hua chose the hip flap, which was big enough.

"It's a pity that the skin flaps of the feet are limited. It would be great if we could have more than one."

Shen Jiachen muttered to himself, while Xie Yuhua, who was at the side, suddenly froze for a moment when he heard Director Shen's words.

"One piece is not enough, how many pieces would be good?"

A hazy picture flashed in my mind, like a jigsaw puzzle, piece by piece.

However, it was just a hasty impression, and Xie Yuhua didn't know exactly where it came from, but it didn't matter.

A bold idea appeared in his mind:

"Like a jigsaw puzzle, several skin flaps from different donor areas can be combined. Before transplantation, these flaps can be spliced ​​together, so that one flap can't cover the wound and the donor area is limited!"

Xie Yuhua was overjoyed, her breathing was slightly short of breath.

Shen Jiachen was very careful, noticing the ups and downs of the director's chest and slightly changing breathing, so he asked:

"Director Xie, what are your findings and ideas?"

Tian Hua also blinked, looking expectantly at Zhi Yuhua. Although Director Xie is a bit old, he is still very temperamental, and it is pleasing to watch.

Xie Yuhua nodded happily, and directly drew on a piece of paper, then shared with the two directors:
"I suddenly had a bold idea, maybe I can solve this complicated problem!"

"This is?"

Looking at Director Xie's few strokes, Tian Hua and Shen Jiachen were a little confused.

"Jigsaw puzzle! This is a jigsaw puzzle, and it is also my vision for the flap repair of patients."

Director Tian Hua looked at the jigsaw puzzle drawn by Director Xie, but was still at a loss.

Shen Jiachen, who was on the side, reacted, and then his face changed drastically, revealing surprise and admiration:

"I understand. Director Xie means that we can try multiple donor area selection flaps, and then, like a jigsaw puzzle, stitch these flaps together to form a composite flap."

"That's right!"

Xie Yuhua really wanted to give Shen Jiachen a high five, but Tian Hua was indeed a bit behind in terms of reaction and understanding.

Xie Yuhua was also very excited that she could come up with such a wonderful idea, she really had aura.

Shen Jiachen is also eager to try:
"As expected of Director Xie, this idea, although wild and unconstrained, is extremely powerful and feasible."

"In this way, we can list the suitable foot flaps that can be used, and then screen and combine them one by one."

Shen Jiachen's mobility is extremely strong, and he is really proficient in the selection of various donor sites and skin flaps for various parts of the human body.

"Dorsalis flap."

While Shen Jiachen mentioned a flap, he drew its outline.

"Second toenail flap."

Shen Jiachen continued to paint, while Xie Yuhua at the side also watched expectantly.

Looking at the two people who cooperated tacitly, Tian Hua was also amazed in his heart. He deserved to be a top expert from the imperial capital.

What kind of savvy and talent does it take to come up with such a compelling plan.

With my own elm bumpy head, I can only use the large skin flap of the thigh in a regular manner, and I would never think of using multiple skin flaps for pruning and reorganization.

"Director Xie, you really have an exquisite mind. You can come up with such a plan. Tian admires, admires."

Tian Hua sighed from the bottom of his heart.

Listening to Director Tian's flattery, Director Xie was in a good mood. Indeed, she also felt that she was really amazing, to be able to come up with such a conceptual idea on a whim.

"When I return to Jishuitan Hospital, I will definitely carry out such a subject in the department. After careful research, it is called the "solution" of Tangram skin flap repair."

Satisfied, Xie Yuhua watched Director Shen Jiachen continue to list various available flaps.

Soon, Shen Jiachen listed more than a dozen donor area skin flaps, and the next step was to screen, trim and reorganize.

"Director Xie, I agree with this idea very much, but there are still two issues that I think need to be discussed."

When Xie Yuhua and Shen Jiachen started to build and reorganize, Tian Hua, as a bystander, clearly thought of several difficulties.

"The first one is that after such reconstruction and reorganization, the suture requirements for the flap are very high. Moreover, various suture techniques will be used to complete this complex composite flap. "

For this problem, Xie Yuhua Shen Jiachen thought about it, it is indeed a problem, but it is not fatal, after all, it is only a suture technical problem, Xie Yuhua can mobilize the power, and personally invite surgeons who meet the requirements to come Assist in surgery.

And Shen Jiachen, who was at the side, also had a candidate in his mind in an instant, and the timing was also very good.

The two directors said at the same time: "Director Tian, ​​this is not a problem. We will solve the suture candidate."

Tian Hua nodded, thinking to himself, if you don't have one, I can recommend one.

However, the second problem is the most deadly:

"The second is the success or failure of skin flap transplantation. The most critical thing is the blood supply. A single flap transplantation often causes vascular crisis, including arterial crisis, venous crisis, and combined arteriovenous crisis. "

"If a multi-leaf tissue flap is formed using a composite flap, how can this problem be solved?"

(End of this chapter)