From small clinic to medical empire

Chapter 119
[Bacteria Killer: The hospital infection process managed by Shi Xiaoya has reduced the reproductive capacity of germs by 50%]

Zhang Zifan can clearly say that he is now the body of the head nurse in Calamity Stone.

Such a humanoid sterilizer is really delicious.

Be aware that the minimum standard for a level 2 operating room is 1 times different from the minimum standard for a level 10 operating room.

However, the 【Elementary Operating Room】of course cannot come under the pass line of the second-level operating room, and the gap between the actual aseptic level and the first-level operating room is not that big.

After Shi Xiaoya's improvement, it basically meets the requirements for brain surgery.

The second assistant doctor Bao Tingwei did the disinfection of the patient's operation area before. Zhang Zifan was worried that this did not conform to the system's judgment, so he specially asked Shi Xiaoya to disinfect the patient again.

After the disinfection was completed, he immediately began to dissect the patient's skull base.

Along the styloid process infiltrated by tumor cells all the way up and inward, Zhang Zifan dissected and protected the blood vessels and nerves along the way.

If you encounter a structure that is indeed invaded by tumor cells, it will have to be resected and ligated.

Finally, after exposure of the posterior fossa region, a border of tumor invasion emerged.

……

If it is an epithelial squamous cell carcinoma or sarcoma that has recurred more than a dozen times, even if the patient's superhuman possession does not die, the tumor cells must have spread all over the body.

Although there may be no tumor cells in the original site, the patient's brain, lungs, liver, and other organs with rich blood supply throughout the body may be stained and cannot be treated by surgery.

Thanks to the characteristics of ameloblastoma, that is, strong local invasion and weak remote metastasis, although these tumor cells aggressively occupied the occipital and temporal bones, they did not enter the cranial cavity by surprise.

To use an inappropriate analogy, the general tumor is like a British guy, occupying colonies all over the world through the ocean, and blooming everywhere.

Ameloblastoma, on the other hand, is similar to Lao Maozi, advancing brutally from the land. The total area may not be much smaller than the British colony, but the land is continuous and there are no enclaves.

This metaphor does not mean that the old man is easier to deal with than the British.

The first is the huge size of the entire tumor, resulting in a long border.

Secondly, although the Russians do not engage in ocean conquests, they do have many "expedition teams" on the border.

There is no ambiguity in “exploring” all the way from Siberia to southern Liaoning.

Therefore, for doctors, it is not easy to remove the huge and widely distributed tumor body, and it is even more difficult to eliminate those scattered "expedition teams".

The only thing they can rely on is "radiotherapy" and "chemotherapy".

Fang Guohua's entire left face was basically removed.

The entire upper and lower jaws have also been necrotic, revealing the white bones.

There are both the role of tumor and the reason of radiotherapy.

Radiation therapy is a helpless move that kills 100 enemies and damages oneself 1000.

And the jaw happens to be highly sensitive to radiation.

If you feel radiotherapy, I dare to die.

Osteomyelitis of the radiation jaw, to some extent, causes suffering to the patient more than the disease itself.

……

If Shi Xiaoya is a humanoid sterilizer, then Zhang Zifan is a humanoid tumor cell detector.

Faced with the patient in front of him who was riddled with wounds, Zhang Zifan could understand the helplessness of the previous surgeons.

It's not that they don't want to expand the resection, but that there is really no room for expansion, and if they expand, it is better to beheaded directly.

Even if Zhang Zifan can see the infected skull and jaw, he can no longer pursue "minimally invasive".

Zhang Zifan could only try to ensure the integrity of the skull base.

However, after resecting part of the occipital and temporal bones, it seems a little bit reluctant.

The biggest feature of the posterior fossa is the huge foramen magnum, which is located at the lowest point in the center of the posterior fossa and connects the cranial cavity with the spinal cavity - where the spinal cord meets the medulla oblongata.

Even if you don't have any medical knowledge, you will know the importance of this part after hearing such a description.

When the integrity of the foramen magnum is destroyed, the patient's central nervous system will not be adequately protected.

"Prepare autologous bone graft, choose ribs."

Zhang Zifan ordered, "Su Feixiang, go get the DSLR to take pictures."

……

For such a major operation, the 3 yuan deposit that Fang Guohua paid in advance must not be enough.

However, as a doctor, it is the minimum professional ethics to help patients as much as possible.

Moreover, the case of Fang Guohua is too visually impactful.

If he can be cured and made into a case, then Zhang Zifan will go to Huaxi and UCLA to give lectures in the second half of the year, and he will not worry about having no content on the ppt.

And putting it on the hospital's official website is also an excellent promotional material.

Especially the overseas version, which is run in a purely commercial model, so it is natural to have a huge advertisement.

……

Rib bone removal is familiar to many people, especially women who have considered cosmetic surgery.

Rib cartilage is one of the most popular rhinoplasty materials nowadays.

A high-level aesthetic doctor will operate a knife on the right subcutaneous fold of a woman, and take out a small piece of costal cartilage for rhinoplasty, leaving a small and hidden scar on the body.

Although this is much more complicated than double eyelid cutting, it is actually not a difficult operation.

But the rib bone removal that Zhang Zifan wants to do is completely different. It requires not only costal cartilage, but also hard bone.

Without considering the aesthetic design of the incision, Zhang Zifan simply opened the donor area and cut the patient's eighth rib.

The reason why so many bones were taken was that while Zhang Zifan was repairing the skull base, he also planned to reshape Fang Guohua's jaw by the way.

It's not for aesthetics.

To be honest, with Fang Guohua's appearance, there is really no hope.

According to the words of many people, it is better to die than to live.

But they don't know how persistent a person can be in order to survive.

In short, the main purpose of Zhang Zifan to reshape his mandible is to improve the quality of life.

Specifically, it is to be able to eat a little food, without having to take a bite, to miss three mouthfuls, and to speak without being so leaky.

In terms of appearance, I can only say that it probably looks more like a person, that's all.

……

Time passed by minute by minute.

The autologous bone was removed.

How to place and how to preform a certain shape are all particular.

Generally speaking, it is necessary to make a guide plate before surgery, or at least to carry out digital three-dimensional reconstruction.

However, the infection of the patient's skull base was unexpected, and the CT report did not detect it, so Zhang Zifan naturally had no relevant preparations.

At this time, [Eye of Preset] once again showed extraordinary value.

After dozens of presets, Zhang Zifan found the best restoration solution.

The costal cartilage was used to reshape the left condylar head.

Using hard bone cutting to form greenstick fractures, the whole bone body is U-shaped, acting as the ascending ramus of the mandible, and the mandible body is clothed.

The cut bone fragments were fixed with small titanium nails to repair the skull base.

At this point, Zhang Zifan was finally done, all that was left was for Yuan Qiang and Bao Tingwei to stitch together.

(End of this chapter)