Release date: 2017-04-01
Yesterday morning, the First Affiliated Hospital of Xi'an Jiaotong University held a news briefing to inform the media about a major innovation in the hospital: On March 29, Prof. Guo Shuzhong and Professor Shu Maoguo led the team of plastic surgery and maxillofacial surgery successfully. The prefabricated ear is transplanted to the patient's head.
Because of the car accident, the right head was seriously injured. After the rescue, the patient’s life was saved, but one ear was lost.
Ji Mo has been to a number of hospitals, and the doctors are at a loss. After many inquiries, he found a famous national ear reconstruction expert, Professor Guo Shuzhong of plastic surgery and maxillofacial surgery in the First Affiliated Hospital of Xi'an Jiaotong University.
Professor Guo Shuzhong, who has worked in the field of plastic surgery for 34 years, is the world's second and the first surgeon in Asia to change his face.
It is understood that the number of patients with ear defects caused by trauma and congenital abnormalities is about 500,000 in China. In order to recreate the normal auricles for small, earless and earless patients, the team led by Guo Shuzhong has created the current fourth generation of ear reconstruction technology after years of technological innovation. At the same time, combined with 3D printing technology, the details of the reconstructed ear are more realistic, and the gully ridges of the ear can appear, which can be "false." Every year, the team recreates ears for around 500 children.
Because the skin loss of Ji's ear is extremely serious, it is impossible to use the traditional method for ear reconstruction. Director Shu Maoguo organized a general professor and professor to discuss. Professor Guo’s team intends to break the traditional ear reconstruction model and find another way. Four months ago, Professor Guo Shuzhong's team successfully prefabricated an ear on his forearm, which was realistic and attracted wide attention from domestic and foreign media. After about 4 months of recovery, Ji’s forearm recreates the shape of the ear and is fully integrated with the forearm tissue.
On March 29th, after careful preparation, a multi-disciplinary force gathered in the hospital took 7 hours. The surgery from the forearm reconstruction ear to the head was carried out in the hospital.
Since the surgery involved the patient's reconstruction of the ear vessel anastomosis, before the operation, Professor Guo Shuzhong and Professor Shu Maoguo used a portable blood vessel detector to reconfirm the position of the blood vessel and mark it on the arm with a red pen. According to reports, the most important thing in the whole operation is to transplant the forearm's ear with the subcutaneous and venous blood vessels of more than 10 cm in length to the head and face and vein to ensure that the forearm is recreated. of".
Immediately after joining the anesthesia team. In order to ensure the simultaneous operation of the two parts of the patient, the anesthesia team not only increased the manpower, but also implemented a precise anesthesia program. In addition to conventional general anesthesia, Doppler ultrasound guided anesthesia of the brachial plexus and neck of the forearm to reduce the postoperative pain.
At 10:40 in the morning, the operation officially began. Professor Guo Shuzhong and Professor Shu Maoguo sat on the 2 sides of the operating bed at the same time, and began surgery on the forearm and head.
According to the pre-trial pre-judgment, Professor Guo Shuzhong looked for subcutaneous sputum and venous blood vessels. However, during the operation of the operation, it was found that the vascular level of the forearm changed due to the patient's previous invasive surgery. Professor Guo used many years of experience to quickly solve the problem of unclear levels, explored the blood vessels, and carefully peeled off. Surgery must ensure that the nerves of the forearm are not damaged, but also ensure the integrity of the blood vessels for transplantation, while also retaining the arm nerves, does not affect the function of the patient's hand.
After one and a half hours, Professor Guo Shuzhong successfully removed the reconstructed ear on the forearm with a 12cm length of iliac vein. On the other side, Professor Shu Maoguo has prepared the position and blood vessels of the head transplanted ear, and the surface arteriovenous preparation is completed and waiting for transplantation.
The next problem is the anastomosis of the blood vessels. Since the three blood vessels are very small in diameter, the process of anastomosis of the entire blood vessel must be completed by means of a microscope, and Professor Shu Maoguo is responsible for this part of the work. He needs to suture 12 needles on a 1.5mm-diameter blood vessel. There are 3 blood vessels, 1 artery, and 2 veins. The blood supply to the transplanted ear can only be guaranteed if the blood vessels are patency.
After nearly one hour of suturing under the microscope, the blood vessels were smoothly anastomosed. At this point, the surgical process has passed most of the time, but in order to recreate the survival of the ear, it must be ensured that the ear has blood supply, that is, the ears that the common people usually say are "living." In addition, efforts should be made to reduce scarring in the surgical field and suture using cosmetic suture materials and techniques.
At this point, the reconstruction has been transplanted to the right side of the patient's head. After the instrument detected, the blood flow of "å’•å’š, å’•å’š" was very clear, the blood supply in the reconstructed ear was normal, and the reconstruction of the ear implant was a complete success.
At today's press conference, Professor Guo Shuzhong and Professor Shu Maoguo said: The difficulty of this operation is that the head has been seriously damaged, and it is difficult to find a suitable blood vessel in the site. Moreover, the blood vessels only have the thickness of the matchstick, and need to be magnified ten times under the microscope, and stitched with more than 10 stitches with a thinner stitch than the hair. While ensuring patency of the blood vessels, it is also necessary to transplant the ears to a suitable position to ensure that they are at the right angle and size, and have a realistic shape to restore their hearing.
At present, the patient's vital signs are stable and he is recovering in the intensive care unit. After two weeks of treatment and monitoring to ensure that the new ear is fully alive, the patient will return to work and meet a new life journey.
Source: China Youth Daily
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