Doctor’s Life Simulator

The three directors came to the conference room. Since Tian Hua's sister Hua's assistant was absent, and no assistant was arranged for a while, Tian Hua came to take care of all the consultations this time.

"The two directors have now buried the affected hand in the pocket 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. However, the choice of this flap repair has always been thought of. not good."

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

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

"Then, a strip of skin flap is used to cover the finger wound in a spiral shape, and a large amount of shredded gauze is compressed and bandaged."

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

"Director Tian, ​​your plan can be said to be a very mature and stable repair plan. The use of mid-thickness skin **** on the thigh and cutting out strip-shaped skin **** for helical coverage can guarantee both technical and later recovery. At least 60 points. If it is an ordinary patient, I have no opinion, but after all, the patient's family and the patient have higher requirements, especially in the later function and aesthetics. This plan is still not good enough. "

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

Shen Jiamo followed Tian Hua's ideas and put forward some of his views:

"I think the selection of the donor site for the skin flap can be discussed again. 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 Jiamo is also a senior expert in the industry, and soon thought of several optional donor areas for the feet:

"The skin flap on the dorsum of the foot, or the toenail flap, is very similar to the tissue properties and thickness of the hand."

Tian Hua and Xie Yuhua also agreed, but they both raised a question:

"The skin **** of these two donor sites are indeed very suitable for hand repair in terms of tissue-specific neurovascular distribution. However, don't forget that the patient's hand is too traumatized. It is difficult to choose a piece that can cover the affected area. flap."

Shen Jiamo also agreed, which is why Tian Hua chose the thigh flap, which is large enough.

"It's a pity that the **** on the feet are limited. It would be nice to have more than one."

Shen Jiacheng muttered to himself, and Xie Yuhua, who was beside him, was suddenly stunned when he heard Director Shen's words.

"One piece is not enough, how many pieces are enough?"

A hazy picture flashed through my mind, like a jigsaw puzzle, which was put together piece by piece.

However, it was just a quick impression, and Xie Yuhua didn't think of the exact source, but it didn't matter.

A bold idea appeared in his mind:

"It can be like a tangram, combining several **** from different donor sites. Before transplantation, these **** are spliced ​​together, so that one flap cannot cover the wound and the pain point of the donor site is limited!"

Xie Yuhua was overjoyed, her breathing was a little short.

Shen Jiacheng was very careful, noticing the undulating chest and the slightly changing breathing of the director, and asked:

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

Tian Hua also blinked and looked at Xie Yuhua expectantly. Although Director Xie was a little old, he was still very temperamental, and it was a pleasure to watch.

Xie Yuhua nodded happily, drew rustlingly on a piece of paper, and shared with the two directors:

"I suddenly have a bold idea that may solve this complex problem!"

"This is?"

Looking at Director Xie's few strokes of the pattern, Tian Hua and Shen Jiacheng were a little confused.

"A tangram! This is a tangram, and it's also my idea for a patient's flap repair."

Director Tian Hua was still at a loss when he looked at the tangram drawn by Director Xie.

Shen Jiamo, who was on the side, reacted, and then his face changed greatly, showing a surprise and admiration:

"I understand. What Director Xie means is that we can try to select skin **** from multiple donor sites, and then splicing these skin **** together like a tangram, and then forming a composite skin flap."

"That's right!"

Xie Yuhua really wanted to give Shen Jiaqi a high-five. In terms of reaction and understanding, Tian Hua was indeed a little worse.

Xie Yuhua was also very excited that he could think of such a wonderful idea, and he really had aura.

Shen Jiamo is also eager to try:

"As expected of Director Xie, this idea, although imaginative, is very tense and feasible."

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

Shen Jiamo is extremely mobile, and he is very skilled in the selection of various donor sites and skin **** for various parts of the human body.

"The dorsal foot flap."

Shen Jiamo drew the outline of a flap while naming it.

"Second toenail flap."

Shen Jiaqi continued to paint, while Xie Yuhua watched expectantly.

Tian Hua was amazed when he looked at the two people who cooperated tacitly. He was indeed a top expert from the imperial capital.

This is what kind of understanding and talent it takes to be able to come up with such a powerful plan.

With his own elm-pimple head, he will only use the large thigh **** in a proper manner, where would he think of using multiple **** for pruning and reorganization.

"Director Xie, he's really thoughtful. To be able to come up with such a plan, Tian admires, admires."

Tian Hua sighed from the bottom of his heart.

Listening to Director Tian's praise, Director Xie was in a good mood. Indeed, she also felt that she was really amazing, and she was able to come up with such a concept.

"When I return to Jishuitan Hospital, I will definitely carry out such a topic in the department. After a good study, it will be called the "solution" method of repairing the tangram skin flap."

Xie Yuhua was complacent and watched Director Shen Jiamo continue to list the various available flaps.

Soon, Shen Jiamo listed more than a dozen donor site flaps, and the next steps were to screen, prune and reorganize.

"Director Xie, I also agree with this idea very much, but there are still two issues that I think it is necessary to discuss."

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

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

Regarding this issue~www.readwn.com~ Xie Yuhua Shen Jiamo thought about it, it is indeed a difficult problem, but it is not fatal, after all, it is only a suture technical problem, Xie Yuhua can mobilize power and invite him personally Qualified surgeons to assist with surgery.

And Shen Jiamo, who was on the side, also had a candidate in his heart 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 important thing is the blood supply. A single skin flap transplantation has often occurred vascular crisis, including arterial crisis, venous crisis, and combined arterial and venous crisis. "

"If a composite flap is used to form a multi-leaflet tissue flap, how can this problem be solved?"

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