When the Doctor Uses A Hack

Yesterday, he received a notification from the First Hospital of Dongyang East University and after learning about the patient Dou Xin’s condition, he quickly organized a departmental case discussion.

This was a challenging case of skin flap transplantation. The irregular scarring involved a substantial area, making effective skin flap transplantation particularly crucial.

Even Wang Yushan, who is adept at this procedure, found it a bit of a headache!

He discussed the matter with several department heads in related fields within the hospital and still could not make up his mind, selecting a few distinctive treatment methods.

Wang Yushan brought out the first plan and slowly said, “Director Qin, the first plan is the axial flap, proceeding according to the island flap technique. Here is the schematic, take a look.”

As he spoke, Wang Yushan projected an image that appeared within everyone’s view. This type of axial flap definitely involves the selection of a free flap with vascular pedicle from the body for composite tissue transplantation.

“Actually, it’s about finding a flap on the body that can satisfy the needs of facial transplantation. Our options include the pectoral arm and scapular flaps, but then the problem we consider is the mismatch with the facial region, though the scapular area can be designed to include the ascending, descending, and transverse branches to supply blood…”

Qin Xiang understood this one; he had also considered it. Relatively speaking, the operation was simpler, but the downsides were more apparent.

For a transplanted flap to survive, it must have sufficient blood supply. The facial vessels are abundant but they are not large vessels, and their compatibility with the scapular region is limited. In fact, the best match would be with the chest, but the chest area was not sufficient!

And most importantly, it was still impossible to preserve the pedicle!

What is a pedicle?

Generally speaking, the best plan for facial skin flap transplantation is still to preserve the pedicle, which keeps the skin flap supplied with blood from its original vessels without cutting them off. This ensures a good blood supply, facilitates future recovery, and most importantly, looks natural!

It won’t give off a strikingly abrupt appearance!

Wang Yushan began to introduce the plans one by one, and everyone listened carefully. Chen Cang sat there, doodling with a pen, after all, many of Wang Yushan’s ideas gave Chen Cang some good conceptions in front of him, which were worth learning from each other.

After an hour, Wang Yushan introduced four methods.

Each method had its own merits!

The attending physicians were impressed, not without admiration for the strength of the Sixth Municipal Hospital!

Such an opportunity for exchange with the Sixth Municipal Hospital was truly rare, and Qin Xiang directly called back all the resting physicians to participate collectively in this remote consultation.

This was also a learning opportunity!

To invite them to the First Hospital of Dongyang East University was not only improbable but would be quite troublesome and invariably involve a lot of effort.

And even if you invited them for a consultation and spent money and effort, at most you could invite one or two people, but to have everyone involved in a discussion like this was completely impossible!

Now, with the help of teleconferencing, five or six directors from the other side joined in to help design and discuss the facial skin flaps for Dou Xin, which was tantamount to a collaboration between the Sixth Municipal Hospital and the First Hospital of Dongyang East University!

It was not only good for the patient but also a valuable learning opportunity for the First Hospital of Dongyang East University, whose skin flap transplantation technology lagged behind!

So, who wouldn’t cherish such an opportunity.

Following the unveiling of the four skin flap transplantation design options, the office of the First Hospital of Dongyang East University fell into a brief silence.

The doctors took up pens and wrote vigorously on paper, constantly recalling the ingenious points from earlier. These were the years of experience from the outstanding specialist directors, highly beneficial for this group of junior doctors!

After a while, Wang Yushan broke the silence.

“Director Qin, which of these plans do you find most suitable?”

Qin Xiang, to be honest, found each plan to have its unique features but he was not completely satisfied with any of them!

None of them reached the level Qin Xiang had expected!

Unable to hold back, Qin Xiang asked, “Director Wang, the first plan has the highest feasibility, but its disadvantages are also very obvious, such as potential issues with post-transplant recovery and the survival rate of the flap. The second plan mainly uses a large amount of A-T transplantation, which results in more noticeable scarring, and the third plan…”

Listening to Qin Xiang’s reviews, Wang Yushan also nodded slightly. He had to admit, Qin Xiang was quite capable; this was evident just from his straightforward and incisive comments, pointing out the strengths and weaknesses.

After Qin Xiang finished commenting, he pondered thoughtfully, recalling a paper scheme, furrowing his brow—he was thinking about a better option.

Suddenly!

A spark of inspiration struck, and Qin Xiang’s eyes lit up, he quickly spoke up, “Director Wang, I have an idea, but I’m not sure if it’s feasible!”

Wang Yushan was slightly taken aback, “I’m not sure what you mean, Director Qin…”

Qin Xiang stood up with a smile, pulling the anatomical model of the office towards him, his eyes gleaming confidently, “Director Wang, look, my idea is to choose from multiple donor areas!”

Upon hearing Qin Xiang’s words, the directors on the television also felt a flash of insight!

Right!

That’s a great idea!

Multiple donor sites can fully compensate for the original shortcomings and expand on the advantages!

Wang Yushan was also filled with curiosity and quickly said, “Director Qin, please elaborate.”

Qin Xiang nodded, “First of all, the patient Dou Xin is still young, only 18 years old, so his plasticity and growth are still very good. Therefore, given this, can we use a variety of skin flap transplant surgeries at the same time?”

“In the cheek area, in this section, we can completely use a V-Y advancement flap surgery, and in the area below, we use a rectangular advancement flap surgery… Finally, in the region from the jaw to the neck, because the area is too long, we create a commensurate skin flap from the thoraco-brachial to scapular area, then preserve the vascular pedicle in the neck to perform a rotational skin flap transplant!”

“By doing so, we can take advantage of multiple free skin flaps, giving the face wound more donor site options!”

“In this case, in the later stages of recovery, there will definitely be a good healing effect!”

As soon as he finished speaking, the office fell into a brief silence!

Then, applause broke out!

In both offices, everyone started clapping for Qin Xiang!

It truly was a brilliant idea, a genius design, a miraculous choice of flaps!

Even Wang Yushan couldn’t help but praise it!

“Brilliant! Absolutely brilliant, Director Qin is indeed impressive. This idea is simply too good! You’ve opened our eyes to the capabilities of First East Hospital. To come up with such a splendid skin flap design plan is beyond most people’s reach!” Wang Yushan said sincerely!

The Director in charge of skin flap transplants at Sixth Municipal Hospital also expressed his amazement and endless praise!

“Exactly! This idea is really too good, Director Qin. Your idea can be described as an eye-opener; it seems we should definitely strengthen communication and cooperation between our two hospitals in the future!”

Listening to the successive praises from the directors of Sixth Municipal Hospital, Qin Xiang truly felt very relaxed and extremely comfortable!

With a sigh, Wang Yushan then said with a smile, “I wonder how Director Qin thought up such a skin flap transplant scheme? I must learn a thing or two from you!”

Qin Xiang was stunned. Right…

How could he come up with such a brilliant design plan?

At that thought, Qin Xiang found it incomprehensible…

He felt as if he’d had a flash of inspiration, as if everything had fallen into place, as though he’d been granted this plan by some divine providence.

Perhaps… this is talent?

After all, no one taught him…

In the First East Hospital’s Department of Dermatology office, everyone was looking at Qin Xiang as if he were an idol. If they could display their inner thoughts as comments, they would all be: 66666666

Director Qin truly lives up to his name, even those from Second Municipal Hospital must acknowledge his skill after seeing this!

Impressive!

However, there was one person who was somewhat perplexed.

Xu Kailin had also turned into a little fangirl of Director Qin. After all, such a genius design is truly beyond the abilities of most people.

With that thought, Xu Kailin picked up her phone, took a photo of the model, and decided to take a good look and study it carefully.

After taking the photo, Xu Kailin zoomed in on the picture on her phone, looked at it closely, and couldn’t help but chuckle. Such a complex design plan, if it weren’t for Director Qin’s detailed explanation, she might not even understand it, right?!

Let alone not understanding it, she might even have mistaken it for a messy doodle, since it seemed completely haphazard and scribbled… just like… random talismanic symbols. But then… all of a sudden… Xu Kailin thought she recognized something familiar!

This realization stunned Xu Kailin!

Right!

Such a familiar style, such familiar lines, so familiar…

She felt like she had seen that drawing somewhere before!

As Xu Kailin was contemplating this, she suddenly saw Chen Cang sitting opposite her, writing and drawing on paper!

She finally understood where she had seen that design plan before!

…