From small clinic to medical empire

Chapter 34 The Eye of Presupposition
It has been nearly an hour since the child was injured. During this period, bacteria remained on the surface of the wound and had not multiplied in large numbers, but the dust and rust on the metal shelf had already entered the tissue.

After Shi Xiaoya injected the child with tetanus vaccine, Zhang Zifan injected anesthetic into her lips.

I don't know if the pain covered up the pain, or the child is more sensible and brave. During the whole process, she only sobbed slightly, and did not cry loudly.

Repeatedly use hydrogen peroxide and saline to rinse the wound, and use hemostatic forceps to remove all rust. The next step is the most critical suturing.

At this time, Yuan Qiang ran over in a hurry. He came by taxi and was still wearing pajamas.

"Get ready and enter the operating room immediately!" Zhang Zifan ordered.

"Yes, Director!" Yuan Qiang went to wash his hands and change clothes without saying a word.

At this time, the child's mother suddenly asked: "Doctor, do you want to go to the operating room? Can't you sew it here?"

For emergency sutures like this, each place has its own regulations. In most cases, it is actually not taken into the operating room, and it is stitched off directly in the emergency treatment room.

The parents watched from the sidelines and felt relieved.

But this child's injury is different, and this is not a situation where simple sutures can solve the problem.

"Doctor Zhang?"

At this time, the child's father was also holding up his mobile phone. A young man about the same age as Zhang Zifan asked on the mobile phone: "You can simply reduce the tension and sew it up first. I will find someone to do the second phase for Hanhan."

It could be heard that this was a colleague, or at least a knowledgeable one. Zhang Zifan shook his head and said: "This is a secondary injury to the child, and there will be more scars, which is inappropriate."

"Then what should you do? Don't just sew it up, otherwise it will become a deformed beak and it will be difficult to deal with!" The young man in the video was anxious.

"Don't worry, I will do the transfer flap."

After leaving a word, Zhang Zifan turned and walked towards the operating room.

"A transfer valve? What is a transfer valve?" The child's mother hurriedly asked her nephew.

At this time, "Xiao Bin" was still in shock, until he was asked several times before he said in a daze, "You... are you sure you came to a small clinic? Not a top three?"

"What the hell do you mean, little bastard, don't be fooled!" The child's father was in a hurry.

"If I understand correctly, what Dr. Zhang said just now is that he plans to perform triangular valve repair on the child, and he is treating Hanhan as a cleft lip!"

"Cleft lip? What is a cleft lip? Little brat, speak in a human language that your uncle can understand!"

"It's a harelip! Dr. Zhang is going to give Hanhan a lip aesthetic repair!
Is the clinic so powerful now?

Even a tertiary hospital with a doctor on duty can't perform this surgery!
To plan a cleft lip surgery plan in such a short amount of time, and to do it in an outpatient operating room...

According to the words that you can understand, Uncle... this Dr. Zhang, he is either awesome or a badass! "

……

That's right, Zhang Zifan planned to repair the little girl's wound by repairing the cleft lip.

The huge wound from the bottom of the nose to the peak of the left lip runs all the way to the vestibular sulcus. Coupled with the massive loss of soft tissue, this is actually almost the same as a patient with a cleft lip.

Cleft lip is not a particularly rare congenital disease, but its operation is very difficult, and few hospitals can perform it.

In many plastic surgery hospitals, the cowhide is blowing loudly, double eyelid cutting, rhinoplasty, and eye opening, as if they are so amazing.

But do they dare to do real "plastic surgery" on the head and face?
Cleft lip and palate repair, full maxillary horizontal osteotomy, mandibular ramus vertical osteotomy, mandibular sagittal split distraction osteogenesis...

These are surgeries that truly change the shape of the skull, jawbone, and soft tissue structure, rather than the so-called "plastic surgeries" that rely on filling prostheses to change facial shape.

Without exception, these surgeries can only be done in tertiary hospitals.

……

Cleft lip repair can be very simple or very, very difficult.

Because if the two sides are directly pulled together and sutured, this is undoubtedly repairing the cleft lip.

It's just that what is created in this way is a patient with microstomia, or a bird's beak deformity, rather than a healthy person with basically normal appearance and no obstacles to eating and speaking.

Therefore, for cleft lip repair, the choice of surgical technique is extremely critical.

Generally speaking, the doctor must make several calculations on the patient's face and drawings before deciding on the final surgical plan.

Dare to make up his mind to carry out this operation in such a short period of time, Zhang Zifan relied on the temporary skills he acquired: [Eye of Preset: When you adopt a certain surgical plan, you can predict the best prognosis of the patient under that plan. 】

At this time, Yuan Qiang and Shi Xiaoya had comforted the child and lay on the operating table.

Under the thick drape, only a square inch of the surgical field of view was exposed.

Zhang Zifan shook his head and ordered: "Remove the facial draping! This is not an infected wound, and it has been fully debrided. The risk of surgical infection is very small. For this operation, we have only two goals: aesthetics! Function!"

Anyone who has ever put on makeup knows that the five senses of the human body must be coordinated and considered. If you only focus on the small mouth area in front of you, the lips produced in this way, no matter how perfect, may be changed when combined with other organs of the face. have to be uncoordinated.

So Zhang Zifan removed the towel, exposing the child's entire face.

At the same time, in order to reduce the irritation to the children's eyes, Zhang Zifan ordered Shi Xiaoya to dim the light of the shadowless lamp.

This undoubtedly increased the difficulty of the operation again.

Zhang Zifan narrowed his eyes, recalling the various techniques he had mastered, and activated the special skill [Eye of Preset].

[Preset: McDowell technique!

Prognosis: If the operation is completed perfectly, the recovery rate can reach 53%]

[Default: Brown technique!

Prognosis: If the operation is completed perfectly, the recovery rate can reach 62%]

[Preset: Rectangular petal spell formula!

Prognosis: If the operation is completed perfectly, the recovery rate can reach 44%]

……

As the spells were passed one by one, finally, two suitable alternatives were placed in front of Zhang Zifan.

[Preset: Inferior triangular valve reconstruction surgery
Prognosis: If the operation is completed perfectly, the recovery rate can reach 82%]

[Preset: Millard rotates and advances the spell formula

Prognosis: If the operation is completed perfectly, the recovery rate can reach 93%]

These two methods have the highest recovery rate among all surgical techniques.

When he was at the First Affiliated Hospital, Zhang Zifan, as the chief surgeon, completed a relatively simple inferior triangular flap surgery.

This surgical method has many advantages, such as clear fixed point, less risk, and relatively stable effect.

But it also has a fatal disadvantage, that is, it needs to further remove part of the patient's tissue, thus forming a long and narrow phenomenon.

However, another surgical method, Millard's rotary push method, is the opposite. It does not need to remove any healthy tissue and minimizes the damage as much as possible.

However, this surgical incision requires precise positioning, which places extremely high demands on doctors.

If there is a slight mistake, it will easily lead to asymmetry of the lips on both sides, which is an unbearable price for this little girl of the same age!

To put it simply, the first method is safe, has low risk, and the prognosis is average. The second method is high risk, difficult, and the prognosis may be very good or very poor.

(End of this chapter)