Dr. Chung’s 90s

Chapter 110 Total Nose Reconstruction

This unexpected incident did not affect Zhong Yu's mood. She was still in the mood to taste steamed buns while in the car.

In fact, I just ate a lot of food at Ji Xueli's house, but I always felt empty without eating the staple food.

Ji Xueli drove the car with a stinking look on his face. When Zhong Yu put food into his mouth, he realized that he was unhappy and comforted him with a smile:

"There are many opportunities to have dinner with your parents. It would be bad if you delay the patient's best treatment opportunity. You can't show off to the director when you go to the hospital later. We are all here, so there is no need to leave anything to say."

Ji Xueli was just in a mood. Today was a very important day for him. He brought his beloved girl to his parents. It was a warm and joyful time, but he let this phone call ruin it completely.

He wiped his face, cheered up and said, "I'm so sorry, you can't live without even eating."

Zhong Yu smiled and touched his shoulder with her own, and said considerately:

"It's not your fault. There's nothing to apologize for. I'm just curious. How could a beautiful girl from the art troupe, who usually spends most of her time rehearsing in addition to performances, have her face disfigured and her nose cut off? How much hatred does this have. "

Ji Xueli was not very clear about the specific situation. He said objectively: "Those who can be accepted as disciples by Commander Cen should have very solid basic professional skills. However, there are many women in the art troupe, and there are many intrigues. It is not impossible for such a vicious incident to happen. .”

Zhong Yu agreed with what he said, just like in the entertainment industry, there is only one good role, and anyone who wants to gain both fame and fortune must fight.

When the two arrived at the hospital, they had adjusted themselves. As soon as they arrived at the door of the emergency room, Zhong Yu saw the frightened dean's wife who was crying.

Seeing Zhong Yu, Cen Xi felt as if she had seen a savior. She rushed to Zhong Yu, took her hand and said:

"A'yu, this child Xin Ning is so pitiful. You must save her. Her face is ruined and her nose is missing. If she can't be cured, she will be finished for the rest of her life..."

It could be seen that Cen Xi cherished her apprentice very much. Zhong Yu patted the back of her hand comfortingly and said calmly:

"Don't worry, Aunt Cen, I will do my best to treat her."

Dean Luo quickly helped Cen Xi aside and persuaded in a low voice:

"What do you have to worry about when Zhong Yu is here? She is a professional doctor. Your crying will delay her time."

Then he said to Zhong Yu: "You two go in and see the patient. I am here."

Dean Luo was worried that his wife was waiting alone at the door. Ji Xueli nodded and followed Zhong Yu into the emergency room.

The doctor who was helping the patient clean the wound suddenly lost his stress when he saw Zhong Yu come in.

He gave up his position without hesitation and said politely: "Doctor Zhong, you should handle it."

Zhong Yu had already changed into surgical clothes and had done cleaning and disinfection. She said calmly while wearing a mask:

"Have you done a full body check on her?"

The emergency room doctor replied: "The examination is good, and the director said that he will wait for you to make follow-up arrangements."

Zhong Yu knew it well and came to the patient. Song Xinning was in a state of shock due to severe pain and panic.

Zhong Yu checked her carefully, and then said to Ji Xueli:

“Examination showed that the entire nose was missing, part of the left infraorbital and cheek soft tissue defects were connected to the superior collar sinus and oral cavity, part of the soft tissue of the upper lip was missing and free, only the right side was connected to the cheek, and the left upper eyelid and globulus were lacerated to the auricle and There was a laceration to the external auditory canal and multiple lacerations to the occipital scalp, requiring immediate surgery.”

Even if Ji Xueli is not a plastic surgeon, he can tell how difficult this surgery is. He said with a solemn expression:

"I will be your assistant together with the emergency physician. You can report any medicines and materials you need, and I will have people ready immediately."

When he said this, it was equivalent to putting pressure on Zhong Yu. This was also an unavoidable choice.

Zhong Yu had no objection to his arrangement, and she quickly got into work mode.

Ji Xueli took advantage of Zhong Yu to debridement the patient and went out to make a call to Principal Yang.

Zhong Yu has already shouldered a heavy responsibility, and he wants her to get the maximum benefit from this matter.

Zhong Yu was highly focused at work. She only had patients in her mind. She didn't know that Ji Xueli was out for a trip.

Debridement and tension-reducing suturing were performed under local anesthesia. Zhong Yu carefully reset and sutured the free and lacerated soft tissues, and then closed the inner wound connecting the oral cavity and the superior collar sinus.

She performed tension-reducing sutures on the large infraorbital cheek defect area to minimize the wound surface, which is more conducive to wound healing.

She did not feel the passage of time while doing this, nor did she notice Principal Yang standing by to observe her operation.

Zhong Yu designed the surgical plan in mind. She used the triangular thorax flap to repair the entire nose and part of the infraorbital and buccal midface defects.

Ji Xueli cooperated with her tacitly. After she first used a leather tube to establish good blood supply, she then performed total nose reconstruction and cheek defect repair.

Based on the length of the skin tube and the size of the infraorbital and buccal defects, she cut off the middle and lower 1/3 of the skin tube, then opened the skin tube, removed the excess subcutaneous tissue, performed total nose reconstruction on the upper end, and performed infraorbital and buccal reconstruction on the lower end. Defect repair.

Zhong Yu first repaired the infraorbital and cheek defects, cut open the lower part of the skin tube longitudinally, removed part of the subcutaneous fat tissue, and then removed the scar tissue of the infraorbital and cheek defects to expose the wound, release the infraorbital area, and reduce infraorbital area paralysis. The scar tissue caused ectropion, and then the skin flap was sutured to the lateral left upper lip, infraorbital and buccal defect edges.

All her movements were smooth, natural and pleasing to the eye. Seeing her ease and ease, Yang Zhao admired her from the bottom of his heart.

Zhong Yu didn't notice his presence. She was about to undergo a crucial step of total nose reconstruction.

The nasal cavity lining is composed of two parts. She sewed the skin and scar tissue at the root of the nose and the wound edges on both sides to form a small part of the nasal cavity lining.

The skin at the lower end of the skin tube is then folded inward to form the majority of the nasal lining and sutured with the upper nasal lining to form a complete nasal lining coverage.

Next, she performs external nose shaping. She trims the outer edge according to the size of the skin flap and the shape of the created nose. The outer edge of the skin flap is aligned with the wound skin at the edge of the plow hole, and the lower root of the nose is sutured with the upper lip wound to form the nostril.

Then columella shaping is performed. The middle part of the skin at the lower end of the leather tube is folded inward, and the lower end is sutured to the middle wound of the upper lip to form the columella.

Finally, the shape and fixation were performed. When the nostrils were supported and fixed, her nostrils were supported and fixed with iodoform gauze wrapped around the catheter. When the nasal dorsum was supported and fixed, she used iodoform gauze strips rolled up on both sides of the dorsum of the nose and sutured with thick sutures. For fixation, the nose wing and side of the nose are fixed with gauze rolls to support the nose shape.

The entire operation was time-consuming and labor-intensive, and the day after the operation was already bright.

Zhong Yu swayed due to exhaustion, and Ji Xueli quickly supported her, his eyes full of anxiety.

Zhong Yu looked at him, smiled, and comforted softly:

"I'm fine. I just stood for too long. The patient can be sent to the ward. Pay attention to postoperative care." The emergency room doctor felt that Dean Ji's eyes were so scary that he didn't dare to breathe. He wanted to shrink down and push the person away.

After the patient was pushed out, Principal Yang couldn't help but ask:

"Dr. Zhong, why did you choose the thoracic triangle flap for repair?"

Zhong Yu was startled by the sudden sound. She looked at Principal Yang with confusion on her face. Ji Xueli quickly explained:

"A'yu, this is Principal Yang. He is here to observe your surgery."

Only then did Zhong Yu understand what was going on. She greeted Principal Yang politely, and then said:

“There are many methods for total nose reconstruction and repair, and the source of skin tissue is mainly skin flap or skin tube transplantation. When I choose the source of skin tissue, in addition to considering the ease of forming the skin tissue flap, I also need to consider that the skin flap must have rich blood supply, color, and The texture should be similar to that of a normal nose, with less shrinkage in the later stage. The skin flap should be thin and tough to facilitate the shaping of the nose structure, and the fixation should be simple and comfortable, and the treatment course should be short.”

Principal Yang kept nodding her head. What she said was very reasonable. Zhong Yu continued:

"Simple total nose reconstruction can be repaired with a forehead flap, forearm flap, upper arm skin tube, abdominal skin tube, thoracoacromial skin tube, etc. Currently, the most commonly used clinical application is the forehead flap, but in this case, due to the large midface defect area , the wound is connected to the oral cavity, nasal cavity, and superior collar sinus, so it is difficult to repair. If the size of the forehead flap is not enough, forehead deformity will occur again. Therefore, it is necessary to find a flap with a large area that can better restore the patient's face. "

Principal Yang was full of praise for her and continued to ask: "What are the characteristics of the pectoral triangle flap?"

Zhong Yu barely had to think, she just opened her mouth.

"The area of ​​the thoracic triangle flap can reach 10cm × 22cm, and it is close to the face. The color of the thoracic triangle flap is similar to that of the face. The skin of the thoracic triangle flap is suitable in thickness and elastic. It can shape the nose alar and columella better and is easier to use. Maintain nose shape.

Through my series of improvements, the thoracic triangle flap has been lengthened and the area of ​​the thoracic triangle flap has been increased, making it more suitable for the reconstruction of large-area defects in the midface, including total nasal defects. "

Principal Yang listened to her eloquent words and recognized her strength from the bottom of his heart. He glanced at Ji Xueli who was protecting Zhong Yu with a smile, and said to Zhong Yu:

"When Xue Li recommended you to me, I thought he was blinded by love and didn't believe how powerful you could be at such a young age. It turns out that I am indeed narrow-minded. Can Dr. Zhong find time to go to the Military Medical University?" Teach the students a lesson?”

Although Zhong Yu was happy to receive his recognition, she was not overjoyed. She smiled gently and said:

"Of course! Thank you Principal Yang for taking time out of your busy schedule to observe the surgery and for being willing to give me the opportunity to communicate and learn with young people."

Principal Yang, who is a sweet-tempered person, burst into laughter when she heard what she said.

"It doesn't sound right for you to say that students are young people when you are so young yourself."

Zhong Yu looked lazy. Her mental age was more mature than that of a student, so it was not easy to refute, so she said softly:

"Then I'll prepare a topic for you to review first, and then go to class when I don't have work here?"

Principal Yang liked young people who were thoughtful and not reckless, so he nodded readily and agreed.

"Then you have to implement this as soon as possible. Young students are thirsty for knowledge. If you come earlier, you can teach them earlier and help them solve their doubts."

Zhong Yu smiled and nodded in agreement. Seeing her dark eyes and eagerness to protect her, Ji Xueli interrupted directly:

"Principal Yang, it's settled. A'yu is too tired, she has to go back and rest."

Principal Yang also liked talents and said cheerfully: "Then I'll say hello to you, Principal Luo, before I leave. You guys have a good rest."

Ji Xueli's intention to drive people away was so obvious that Principal Yang couldn't even stay and chat more.

Zhong Yu was directly packed up and sent home to sleep, and then he drove back to the hospital alone to handle the follow-up matters.

She worked all night under such high-intensity conditions, and she really couldn't go to work during the day. She went home and slept in a dark place, and didn't wake up until about four o'clock in the afternoon.

She also has a small night shift at night. She has enough rest during the day and is embarrassed to leave the night shift to others at night.

Get up, quickly dress and wash, go to the hospital cafeteria for dinner, and then go to the office.

Chu Jianwen was also on duty at night, and when he saw Zhong Yu exaggeratedly said:

"It's so pathetic. In one night, we, Director Zhong, were so tired and thin. Look at his thin face."

Zhong Yu ignored her and walked straight to his office.

Chu Jianwen followed her obediently, chewing an apple and said carelessly:

"Why do you think Aunt Cen's apprentice had his nose cut off and his face disfigured in public?"

Zhong Yu put the bag in the cabinet and shook his head in cooperation. Chu Jianwen opened the conversation and said with disdain:

"I saw Song Xinning at Aunt Cen's house when her face was not ruined. She was not as beautiful as you. She looked weak and weak. She cried at every turn. How could she dare to seduce a married man in private? The first wife went crazy and wanted to ruin her face, and she deserves it."

Zhong Yu was very surprised, "Since the dean's wife has accepted her as her apprentice, is it possible that she should not inquire about her personality?"

Chu Jianwen swallowed the apple in his mouth and said nonchalantly:

"Actually, Aunt Cen is very well protected by Dean Luo. She can't tell the difference between good and bad people. She relies on her feelings to get along with people. That Song Xinning is very thoughtful. She pretends to be clever and acts in front of Aunt Cen. It's very... It’s easy to gain her favor.”

Zhong Yu thought about Cen Xi's personality and found that it was indeed relatively simple and simple. She asked curiously:

"Then how do you know the truth?"

Chu Jianwen threw the apple core into the trash can and said calmly:

"That stinky man who was always busy, his wife never stopped doing anything and wanted to kill Song Xinning in the hospital, but she was caught on the spot. She yelled like it was a joke. Everyone knew about it. How could she hide it? Live."

Zhong Yu frowned and said worriedly: "Isn't the dean's wife very sad?"

Chu Jianwen nodded, "Aunt Cen was taking care of her in the ward at that time. She was concerned that her family was far away, so she wanted to take care of her more. Who knew she would hear such a truth? She was also very angry."

Although Zhong Yu had never seen Song Xinning when her face was intact, judging from her bones alone, she should look pretty good.

She is an artistic female soldier who was born in the art troupe. With Cen Xi as the regiment leader and master, it should not be difficult to marry an officer in the future, so why ruin her future.

She couldn't figure it out, so she told Chu Jianwen directly. Chu Jianwen was very knowledgeable about this matter, so she wasn't surprised at all.

"You think those people are fools, then Song Xinning is just a girl from a fishing village, her family is very poor, no matter how beautiful she is, others are not willing to help the poor.

Besides, who doesn’t want to climb up? Anyone with a family background and a high status would never fall in love with a woman like her. She didn't want to care about her when she had no future. She was getting older, and if she couldn't get married before retiring, she would be like that for the rest of her life. "

Zhong Yu understood that she was in a hurry and sought medical treatment.

Chu Jianwen gloated: "She probably didn't expect that even though his wife is an uneducated rural woman in the countryside, she has a fierce spirit. She also has a pair of children. They will keep her safe no matter what. If Song Xinning's reputation is ruined, the future will be miserable." ”

Zhong Yu only felt sad. If these two women had loved themselves more and not pinned their future lives on useless men, they would not have reached this point.

(End of this chapter)