Chapter 121: Auricular disconnection and replantation
Jiang Dalian picked up the wine glass and said to Yao Wenyuan with sincerity on his face:
"Thank you for your strong support, Shenzhen City has your leadership, that is the blessing of our ordinary people, I drank this glass of wine, you are free!"
He drank the wine in the cup heroically, Yao Wenyuan took a sip of face, and then said:
"There are a lot of lesbians here today, let's drink less and eat and chat with them more, just as a small gathering between friends, don't be too polite."
His original intention was to use this dinner to repay the favor, and he would not owe each other anything in the future, but now the appearance of Ji Xueli has made him change his mind, and maybe it will be more cost-effective to befriend him.
Some people are born like this, they like to take one step and count three steps in whatever they do, and they always think about maximizing their profits.
It can't be said that such a person is bad, but it is still necessary to keep an appropriate distance from him.
Yao Wenyuan set the tone for this dinner with one sentence, and everyone else also knew it.
Zhong Yu didn't have any ideas in her heart, she didn't come to make friends, she had to have the mentality of socializing.
Li Siqi was exquisite, and seeing that Zhong Yu and Liao Sha were close, she leaned over and asked curiously:
"Are you two college classmates? Aren't you also a doctor? ”
Liao Sha positioned herself as a foil, and she didn't expect Li Siqi to take the initiative to come over, she said with a smile:
"Yes, Mrs. Yao, the three of us are classmates, and Zhong Yu and I have lived in roommates for many years."
Li Siqi said enviously when she heard this: "You two have a really good relationship, I have never lived in a dormitory in school, and there are almost no good female classmates."
Liao Sha was very polite to people she didn't know, and she said gently:
"When we were in school, we were either busy with classes or internships, and we didn't think it was so good at that time, but now when we look back and look at it, I really think it's very precious."
Li Siqi took the watermelon sent by the waiter and handed it to the two of them, and said in a brisk voice: "Then which hospital are you working in now?"
Liao Sha shook her head with some regret and said with a wry smile: "I used to work in the Capital Hospital, and then I resigned when I got married, but I will look for a new job in Shenzhen in the near future."
Li Siqi is a person who has come over, and she understands it without words, and she can understand her state of mind very well, and said with a smile:
"Actually, it's not bad to work in Shenzhen, we also have to stay in Shenzhen for several years, and we can go out shopping and eat together when we have time."
Li Siqi likes to go out for a walk in her spare time, and Liao Sha is also a highly educated woman, and she still has a common language.
has many friends and many roads, Liao Sha is willing to make friends with her, the two talk happily, and even make an appointment for the next time they go shopping together.
Zhong Yu waited for the two of them to chat, smiled and took out a beautifully packaged box and pushed it over.
"Sister Siqi, this is a skin care product developed by myself, which has the effect of whitening and freckle removal, you can try it."
Li Siqi took the gift box with surprise in her eyes and couldn't wait to open the box.
The skin care products she usually uses are all international brands, and the gift box given by Zhong Yu doesn't even have a logo, but out of confidence in her ability, Li Siqi feels that this must be a good thing.
She touched her face and said helplessly:
"After I gave birth to my daughter, I didn't know what was going on on my face, I had a lot of freckles inexplicably, and I couldn't get rid of it with a lot of skin care products, so I could only cover it with powder, and I was covered with a thick layer on my face, which was not breathable, and it was really uncomfortable to sweat a little when I went out."
Zhong Yu opened the bottle cap for her, and said without hurrying:
"Sister Siqi can try this cream, you can see the effect in about half a month, the packaging is relatively simple, but it is made by hand, it is all pure plant extraction, and there will be no other side effects."
Zhong Yu has a cautious personality, and what he smears on his face is not something that can be used with any material.
Li Siqi became even more curious after hearing this, she took the cream and put it under her nose to smell the smell, and said with a look of surprise:
"This fragrance is so good, there is a kind of spring breath, fresh and elegant, fragrant but not greasy."
Liao Sha also came over curiously, she gently fanned the fragrant wind with her hand, and sniffed carefully with her nose.
"It really smells good, old man, you are eccentric, such a good thing, don't you have my share?"
Liao Sha is not a delicate pig girl, she has a big temperament, she never takes skin care seriously, even if she comes out to meet people, she just picks it up casually, and it is not rude.
Zhong Yu smiled: "How could there be no shortage of you, here."
She took out another bottle from the bag, Li Siqi had a box, but hers didn't.
Liao Sha didn't mind, she took it excitedly, couldn't wait to open it, and smeared it on the back of her hand with her fingers.
The white cream melts into the skin and moisturizes it immediately after being pushed away, and the fragrance of the cream is better smelled by the body temperature.
Liao Sharu couldn't put it down if she got the treasure, "Old man~ You are so powerful, this fragrance smells good, and I feel very moisturized, and it is slippery to the touch." ”
Li Siqi heard her say so magical, and couldn't help but reach out and touch the back of her hand, and deliberately touched the back of her other hand.
She was amazed at the effect of this cream, and couldn't wait to open her own portion, and also applied some to her wrist, gently kneaded it, and raised her hand to put it under her nose. With a face full of intoxication, he said:
"This delicate and moisturizing feeling is so comfortable, and when it blends with the skin, the fragrance is different."
Liao Sha also sniffed the back of her hand and said in surprise: "There is a dark fragrance with sleeves~ This is the feeling."
No matter how old a woman is, she loves beauty after all, Zhong Yu said gently:
"The fragrance is not strong, but it will blend with the body fragrance, different people emit different flavors, and the fragrance can last for a long time."
Zhong Yu understands women's minds, so the products she developed are not worried that there is no market.
Jiang Dalian also came to Liao Sha, he picked up the cream, and asked in surprise:
"You developed and blended this all by yourself?"
Zhong Yu nodded, this was not a difficult problem for her, she explained softly:
"The fragrance is a selling point, but the effect of whitening, hydrating and freckle removal is the most important, you can carefully observe the skin condition of Sasha after use."
Jiang Dalian did not doubt the authenticity of her words, and said excitedly:
"This cream can be our main product, do you have a name?"
Zhong Yu said without thinking: "Then call it Huayan, you don't have to take a too complicated name, when your company is ready, you can put it into production, Huayan alone is not enough, you have to set up a research and development department as soon as possible."
Jiang Dalian didn't expect her to move so fast, which invisibly gave him a little pressure, he patted his chest and promised:
"Don't worry, boss, I will do this as soon as possible, and I will never hold you back."
Zhong Yu put down the teacup in his hand and said softly: "Quality problems are always the first, it doesn't matter if you make money later, our reputation must be good from the beginning, I just ask you about the management model, but there are strict requirements for product quality, do you understand what I mean?"
Even if they are classmates, ugly things still have to be said in front, so as not to be confused when they get it.
Jiang Dalian is not just a one-pole deal, of course he knows that the quality of long-term development is the key, and now that Zhong Yu's attitude is displayed, he has no scruples.
"Don't worry, I'm not a person who doesn't know what to do."
Although Yao Wenyuan didn't say anything, he admired their attitude to work, and he could rest assured that he could cooperate with such a person.
It's almost ten o'clock when the dinner ends, Yao Wenyuan has been committed to making friends with Ji Xueli, although Ji Xueli doesn't like to socialize, but he is willing to make an exception for Zhong Yu, and the atmosphere is harmonious.
After separating from them, Zhong Yu sat paralyzed in the co-pilot when she got into the car, and she complained to Ji Xueli:
"In the future, I'll try to participate as little as possible on occasions like this, it's more tiring than having surgery."
Ji Xueli rubbed the top of her hair and whispered comfortingly: "I'll give you a hot bath when I go back, and then give you a massage to relieve your fatigue."
Zhong Yu turned his head sideways, looking surprised, "When did Dean Ji learn this skill?" ”
Ji Xueli was driving the car to the main road, and when he heard this, he wrote lightly:
"This is not a difficult thing, I am very clear about the acupuncture points of the human body, and I dare not say anything else, I can still do it to loosen your muscles and bones."
Zhong Yu smiled with a satisfied face, although her body was a little tired, her spirit was happy, and she didn't need to worry too much about it later.
She is very optimistic about Jiang Dalian, he can make a career in his last life, and he will definitely be able to do it in this life.
After washing up after going home, Zhong Yu lay on the bed and looked at the book, and Ji Xueli kneaded her shoulders very measuredly.
She held her chin and asked casually, "What do you think of Yao Wenyuan?"
Ji Xueli didn't care too much and said: "He is a smart man, although he has a utilitarian heart, he also has principles, and he can still come and go."
Ji Xueli looks at people very accurately, although Yao Wenyuan tried his best to be good friends with him at tonight's dinner, he was always neither humble nor arrogant, and he was a principled person.
Zhong Yu suddenly turned sideways, Ji Xueli's hand touched a softness, he frowned slightly, did not retreat, Zhong Yu slapped his hand away, and said angrily: "Don't come nonsense, tell you about business."
Ji Xueli had already been distracted, how could he still have the heart to tell her about business, turned over and trapped her, and rubbed her face badly with the sharp stubble, Zhong Yu dodged uncomfortably, and the two twisted into a ball after a while......
The next day, Zhong Yu sat in the clinic and felt that her back and legs hurt, she beat her waist to relieve it, and silently complained in her heart about someone's lack of moderation.
She was about to ask the nurse on duty to call the patient to come in, when she heard someone hurrying and shouting:
"Director Zhong, there is a patient with a severed ear in the emergency room, and you need to help rescue him."
Zhong Yu stood up with a serious face when he heard this, "I'll come now." ”
She trotted all the way to the emergency room, and Director Sun of the emergency room said very quickly:
"Director Zhong, the patient's right ear hit the metal door frame and caused the right auricle to be almost completely severed, only a little skin with 0 width left at the earlobe was connected to the severed ear gallery, the disconnection ratio was more than 95%, the broken edge was not neat, the pollution was serious, the diagnosis was the right auricular tear and fracture, the patient was still clear when he first visited, but he was irritable, short of breath, pale, and weak pulse."
Zhong Yu nodded in understanding, she put on her mask, and looked down to see that most of the patient's shirt was soaked with blood, and the wound was bleeding nonstop.
Everyone knows that auricular dissection and replantation surgery is difficult, and whether the replantation can be successful depends on age, injury mechanism, integrity of the auricle, and the condition of the auricular blood vessels.
The auricle is rich in blood supply, although the skin has double blood vessels, but for the completely severed auricle, the anterior auricular blood vessels are generally thinner, most of them are capillaries, and there is no anastomosis condition, and the available blood vessels behind the auricle are also limited, such as the disconnected part of the auricle is smaller, and it is more difficult to replant.
After Zhong Yu checked the patient's physical condition, he said calmly: "The hair around the ears is prepared for skin, and the operation will be performed immediately."
Patients with complete amputated auricles should undergo amputated ear replantation as soon as possible to reduce the degree of necrosis of the severed auricular tissue.
The anesthesiologist follows the instructions to perform anesthesia immediately, and after the patient is successfully anesthetized, the towel is routinely sterilized.
The nurse repeatedly rinsed the wound with saline, Zhong Yu treated the wound again, she rinsed twice with hydrogen peroxide, and then trimmed the pinna rim.
This is followed by further debridement under a 10x microscope to remove dirt from the wound.
She was preoccupied with finding the severed end of the vessel in the wound on the lateral side of the auricle according to the residual hemorrhage point, and marked it with microsutures.
The arteries and veins and nerves that can be kissed are mainly found behind the auricle, and the debrided and labeled isolated pinna are wrapped in heparin saline gauze.
She inserted a sterile cotton ball into the patient's external auditory canal and performed debridement under a microscope on the proximal stump wound.
Similarly, the posterior proximal wound of the auricle is sought and marked for vascular nerve disconnects.
She was careful at every step, not allowing herself to make the slightest mistake, and the doctor who was her assistant unconsciously held her breath for fear of disturbing her.
Zhong Yu reduced the auricular cartilage section, appropriately separated the skin on both sides, and used 5/0 absorbable sutures to intermittently suture to fix the cartilage on the inner and outer sides of the auricle.
The suture requirements are extremely high, and it should not penetrate the cartilage plate and should not be too dense, so as not to affect the local blood circulation and cartilage healing.
The interval between each suture is about 0.5 cm, and after the cartilage suture is completed, 1 needle is sutured on the skin at the outer edge of the auricle and fixed on the cheek, so that the auricle is tilted forward as a whole, so as to facilitate the exposure of the blood vessels behind the auricle.
Under a ten-fold microscope, she removed the severed ends of the vessels on both sides according to the marker line, trimmed the orifice of the blood vessel, and flushed the lumen with heparin saline to remove the embolus in the lumen of the vessel.
The proximal vascular orifice is clamped at the orifice, the artery and vein are anastomosed by the fixed-point method, the nerve is joined by the adventitial method, and then the vascular clip is released.
Because there was blood leakage from the patient's vascular anastomosis, Zhong Yu added another injection.
The patient's vein is difficult to find, Zhong Yu waits for the arterial blood to gradually fill the outer auricle, according to the bleeding to find the vein, anastomoses as many blood vessels as possible, accurately aligns the skin edge, and uses 5/0 absorbable threads to intermittently suture the inner and outer skin of the auricle, and the suture is suitable for tightness, which can not compress and affect the blood flow of the subcutaneous blood vessels.
The whole operation took more than 6 hours, and Zhong Yu was in a state of high concentration throughout the whole process.
After the operation, she loosely bandaged the front and back of the auricle with sterile gauze blocks, turned her head and told the nurse, "Pay attention to local heat preservation."
Then he injected the patient with tetanus antitoxin and continued to advise:
"The patient was routinely treated with antibiotics for 3 days after surgery, improved microcirculation and anticoagulant drugs for 7 days, and after the patient was sent to the ward, the blood vascularization was closely observed."
After Zhong Yu said this, she motioned for them to push the patient out, and then she pulled down the mask and took a deep breath, because after wearing the mask for a long time, there were marks on the back of her ears and face, and she felt a little uncomfortable.
The emergency room door opened, and they pushed the patient out, and when Zhong Yu walked out, he saw Ji Xueli standing outside the door waiting.
He stepped forward and handed her a bottle of water and asked softly, "How is the patient?"
Zhong Yu said with a calm expression: "The operation was very successful, and there is no big problem with careful postoperative care, how did the patient get injured?"
Ji Xueli said calmly: "He was injured by the malicious attack of gangsters when he was on a mission, fortunately, his companion appeared in time, otherwise the consequences would be more serious, just save people, it's hard for you."
Zhong Yu waved her hand indifferently, it didn't matter if she was tired, as long as she was busy and valuable.