**The method of reconstruction is divided into autologous flap reconstruction and prosthetic reconstruction. Flap reconstruction is the latest technology in reconstructive surgery to create the most natural-looking product. In this method, the doctor removes tissue from the patient's body tissues such as the back or abdomen to make skin flaps, skin, fat, and muscle to create new **.

Luo Kaiyuan's surgical plan did not choose one of these two methods, but a combination of the two methods, that is, to remove tissues from Chang Xinya's back to make skin flaps and skin, but because Chang Xinya's breast glands are completely missing, there are too many tissues needed, and it is impossible to take them all out of her body, which will cause the collapse of the material location and affect the aesthetics, so Luo Kaiyuan decided to take a part of it, and the other part is filled with prosthesis.

But it is inevitable to encounter the problem of blood vascularity, which is also one of the reasons why Bei Yiming's brows are tightly furrowed, and he wants to phrase it: "Teacher Luo, how to solve the problem of blood vascularity?" ”

Luo Kaiyuan went there with a black frosted thermos cup, soaked in the best Pu'er, he put the thermos cup aside and said with a smile: "That's a good question, according to the patient's situation, I brought Yu Yujiang, director of the microsurgery department of our hospital, who is responsible for vascular anastomosis." ”

Yu Yujiang was wearing a black-framed glasses, in his forties, black and thin, there was no smile on his face since he came in, as soon as Luo Kaiyuan mentioned him, Yu Yujiang first stretched out his hand to hold off his glasses, and then coughed and said: "During the operation, I will be responsible for dissociating some arteries and veins in the pectoralis major muscle, and then anastomosis with the blood vessels in the donor to provide blood supply for the patient's breast gland." ”

Bei Yiming looked at Yu Yujiang and said: "Teacher Yu, I'm not questioning your skills, but the donor tissue is already small, there won't be too many blood vessels in it, let alone too many blood vessels, how many blood vessels can you anastomize?" If there is a lack of donors, it is very easy to develop necrosis. ”

Bei Yiming's question is very acute and realistic, as he said, there will not be too much donor tissue removed, how many blood vessels can there be in such a small number of donor tissues? Most of them are still capillaries, and microscopy is not yet able to match these capillaries with the arteries and veins that are free from the pectoralis major muscle. If the number of anastomosed blood vessels does not reach a certain standard, the donor tissue will not be able to obtain sufficient nutrient supply, and it is extremely easy to necrosis.

Yu Yujiang naturally knew about this situation, but he was dissatisfied with Bei Yiming bringing it up in front of so many people. Thinking that the doctor was too faceless for him, he said unhappily: "You don't have to worry about this, I will naturally anastomosis as many blood vessels as possible during the operation to provide sufficient blood supply for the donor tissue, what you have to do is to cooperate with us to do a good job before the operation." Let the patient face the surgery in the best condition. ”

Yu Yujiang is very aware that in Chang Xinya's situation, the chance of necrosis of the donor tissue after surgery is as high as 60%, but in his opinion, surgery is risky, and who can guarantee that any surgery will be 100% successful?

Since the patient and his family have a strong desire to have this surgery and are willing to give money, he doesn't care so much, and does it wholeheartedly during the operation, whether the patient's reconstructed breast will be necrotic after surgery, then let it be fate. He took the money and returned to the capital, and the future has nothing to do with him.

Chang Yuan, as a family member, naturally wanted to participate in this preoperative case discussion, and when he heard Bei Yiming's words, he said impatiently: "Why do you have so many things?" How is your technique better than that of Professor Luo and Professor Yu here? Honestly listen to it. ”

Bei Yiming felt quite aggrieved, he didn't have much to do, but he was worried about Chang Xinya, the chance of failure of the operation was too great, once it failed, her desire for breast reconstruction would be shattered, and she would have to endure greater pain, and the double torture of spirit and ** was likely to make her completely break down. She will be replaced with a strict mental illness, which can range from depression to suicide.

Rather than this, it is better not to have surgery for the time being. When there is a better way to do it, so that at least she does not have to bear physical pain, and her desire to become a complete woman will not be shattered, and she can save a lot of medical expenses, Luo Kaiyuan, Yu Yujiang, and other big experts and professors from big hospitals will come to give her an operation. The cost of the operation is not counted, just the hardship fee for them, I am afraid that each person is at least 50,000 yuan, and the assistants they bring will have to give 20,000 to 30,000 yuan each, plus their food, accommodation and travel expenses, this money alone will cost more than 200,000 yuan.

Bei Yiming could see that Chang Yuan's family was not too rich, not to mention that this money would bankrupt their family, but it was not far away, and it was okay to cure Chang Xinya's injury, but if it couldn't be cured? At that time, it will not only be a heavy blow to Chang Xinya, but also a heavy blow to Chang Yuan's family.

If it were another doctor, I would probably not be talking about anything, I kindly remind you that surgery is risky, and it is best not to rush into surgery, but your family not only does not appreciate it, but also ridicules me, why do I care about this idle matter? Anyway, it's you who spend the money, and it's you who suffer after the failure of the operation, and it doesn't have anything to do with me.

But Bei Yiming really couldn't watch Chang Xinya take such a big risk, he still said: "Teacher Luo's prosthetic reconstruction, the short-term effect is good (including short-term benefits), and the long-term is not satisfactory." If you encounter prosthesis rejection, leakage, and seroma, it will be even more troublesome. Even if you put the posterior gap of the pectoralis major muscle, after a few years, there will be two pieces of paper left, a layer of skin, and a layer of pectoralis major muscle wrapping that is as thin as skin, how beautiful can it be? ”

This problem is more acute and more realistic, the shortcomings of prosthetic reconstruction have all been said by Bei Yiming, the biggest problem of prosthetic reconstruction is atrophy, even if there is a part of its own tissue filling after a few years, there will be two pieces of paper left, a layer of skin, so what's the beauty? At that time, the patient will be more painful, both mentally and mentally, especially a young woman like Chang Xinya.

This sentence suddenly made Luo Kaiyuan a little annoyed and angry, does this kid understand the rules? Why do you always dismantle the table, you are a doctor, you are not a family member of the patient, you are on the other side?

Luo Kaiyuan said impatiently: "I have taken these things into account myself, the prosthesis will choose the best, you don't have to say more, go and see the patient, see the liquid, change the medicine for the patient, don't get infected." "Luo Kaiyuan is calling Bei Yiming as a junior doctor who has just come to the hospital and is on rotation.

Chang Yuan was also a little worried when he heard Bei Yiming's words, and looked at Luo Kaiyuan and said, "Professor Luo won't really become like that after surgery, right?" ”

Luo Kaiyuan knew very well that this situation could really happen in a few years, but he still said: "We use the best prosthesis, and the probability of this situation will not be too low." (To be continued.) )

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