To put it simply, the allogeneic transplantation of anti-rejection genes is to use piglet skin. The active piglet skin is induced by implanting various factors to make it look like human skin genes, and then transplanted into the human body, allowing them to interact with the human skin. The perfect union of the human body.
In a nutshell, Professor Li Housen and his team have been working hard for almost ten years. They started research when they came back from the United States. In terms of surgery, he was not as good as his Korean-American brothers. However, his strength lies in research. Finally, we had some ideas, but it turned out that it couldn't be promoted clinically. Really, Lao Li was heartbroken.
"Small curette, syringe."
Facial repair began. Zhang Fan gently scraped the originally slightly white skin along the texture with a curette. His own mucosa and fat transplantation had to be performed first.
Burns are so abominable. It's not like a knife or an ax, going straight in and out, but a very complex and compound injury.
After the scalded tissue was removed, the injured area was filled with pits of various sizes, just like the ground that had been bombarded by artillery shells on the battlefield. This was the case on the wounded's face.
"Open the mouth." Lu Shuyan used the mouth opener to open the patient's mouth without any confusion. Zhang Fan has a syringe in his left hand and a scalpel in his right hand. While rinsing, use the scalpel to start selecting materials along the mouth.
The wounded man's face was severely damaged. Fortunately, his eyes and nose were saved, but his lips were burned like rotten plastic that had shrunk together.
If this place is not repaired, it will only get tighter and tighter in the future. Because the texture of the perioral muscles is a circle of ring-shaped muscles, which is actually a bit rougher. The structure of this place is similar to that of the anus. Just one more red lip.
Do your best if you do what you want, this is Zhang Fan's belief. The purpose of selecting the mucous membrane in the mouth is to create a new rosy lip.
This mucosa must be provided autologously, and there are very few places to take the material. Only the oral cavity and vaginal canal can supply limited mucosa. Therefore, for male patients, it can only be successful once, otherwise there will be no place to take the material.
"Hemostatic cotton." Zhang Fan used a scalpel to cut out a rectangular piece of mucosa with a vascular pedicle from the cheek. "Needle holder, absorbable thread." Suture the mouth.
"Baoyin, put the mucous membrane into the curved plate and pour in the physiological fluid." Zhang Fan explained.
"good."
After the mucosa is placed, next comes the fat. The best place for fat transplantation is abdominal fat. Fat in other places is too dense and is prone to liquefaction and necrosis. It is too simple to remove fat. Just open the skin, cut it with a scalpel, and suture it directly after cutting.
Repair first. In fact, it simply means digging out the east wall to make up for the west wall. Lu Shuyan's hands were almost bruised. The girl couldn't see any fat now, especially the fat in the abdomen.
After preparing the materials, Zhang Fan began to repair the crater-like face, first filling it with fat. Fat transplantation is very strange. Fat taken from the abdomen will be absorbed when placed elsewhere.
And the absorption is very powerful, as if being eaten by the body, it can reach almost 30% of the filling volume. Therefore, when filling, you cannot fill as much fat as the hole is. You must make adjustments to prevent future absorption. If you do not make adjustments, you will wait for transplantation. After the pig skin is peeled off, there will be collapse. The bigger the pit, the more severe the collapse will be.
Professor Li Housen and Professor Yan Dehua watched Zhang Fan perform the operation in an orderly manner, and their originally raised hearts dropped slightly.
Although the two did not speak, they looked at each other. The meaning is clear: "Judging from the current method, it is not a stick!"
Fat transplantation involves a liquefaction process. The larger the fat area, the more serious the liquefaction, because the larger the area, the more damaged fat cells there are. Therefore, it is best to extract fat beads under a microscope. The size of this thing is 4-6mm. The first person to use this was the Korean beauty industry.
Filling the holes one by one with fat, the face that was originally torn and torn by Zhang Fan's scratches seemed to be covered with cream on a birthday cake, piece by piece. They are exactly the same, both white and convex.
It's really like a person whose face is covered in blood, and then he is covered with pieces of birthday cake.
After the filling is completed, the allogeneic skin begins to be covered. The time has come to show off the technology, especially Professor Li Housen, who almost held his breath.
In the large conference room outside the operating room, a group of big names in the northwest transplant field were whispering. The leader who was watching watched for a while and then left. It was too boring and could not be understood! These are the experts left.
"Old Chen, it's okay. Your undergraduate students in Lan City are so awesome. They've only graduated a few years ago and they're already so skilled."
"Nonsense, what do you think?"
"Shameless thing, as if he's your student." The other party didn't know how to chat. The professor who spoke was a little angry and full of slander.
In fact, his tone was a bit contemptuous of Lanshi, after all, he was further south.
"It's okay, it depends on what happens next. Any doctor in our department can do this step." A director of the Army Hospital said to the Air Force doctor beside him.
"Um!"
The pink and tender pig skin, probably still a pre-monthly pig skin, has been soaked in various potions and is a bit swollen. It curls together like fruit peel that has been soaked in water.
"Alice forceps, four pairs. Director, come and help me open it, Lu Shuyan, come and open it slowly, don't use too much force." The piggy skin with the vascular pedicle is too thin, so use too much force. It may be burst.
When the pig skin was opened, Professor Li Housen's heart almost jumped out of his throat. If you can't do this step well, you don't have to look forward to anything, and you won't be able to do the rest.
The three of them had equal strength, "Come, go down slowly, come slowly, don't rush, come to the left, come, let go." Zhang Fan was also nervous. The assistant in the system can do whatever you say, but he can do it. It doesn't work in reality.
"Fix the ophthalmic forceps, quickly." The position is very good, completely covering the wounded person's face. At this time, look down from the shadowless lamp. Just like a faceless man, his eyes, nose, and lips are all covered.
Fixed, Zhang Fan moved faster and faster. After the pig skin was separated from the physiological fluid, if it could not be quickly connected to the circulatory system, it would become necrotic.
To start the operation under the microscope, first establish the channel. Allogeneic transplantation cannot damage the inner layer of human blood vessels, because various signaling factors will be exposed after damage. Once exposed, the human body becomes a battlefield.
Under the microscope, the hemostats are opposite to each other, pinch the blood vessels of the human body, and pull off the outer mold of the blood vessels. The blood vessels of the human body can be roughly divided into three layers. The inner layer of membrane is home to a large number of factors, the middle layer is the muscle layer, and the outer layer.
The inner layer is the most sensitive, the middle layer is the slowest, and the outer layer becomes sensitive again. The inner layer cannot be destroyed. Once destroyed, it can release various factors and mobilize various soldiers. The outer layer can be destroyed by pulling off the outer layer of the interface. .
Then the skinless blood vessel head is inserted into the inside of the blood vessel of the piglet skin. The muscle layer of the human blood vessel is attached to the inner layer of the piglet's blood vessel. The muscle layer does not matter, as long as there are clothes to wear it.
Then comes the suturing, and here comes the difficulty. The suturing at this time has to penetrate the blood vessels of the piglet and pass through the vascular muscle layer of the human body, but cannot penetrate the inner layer. It is really like doing a dojo in a snail shell, and there are not hundreds of them. Who dares when muscle memory has not been developed after thousands of exercises? Who can? .
Sew one by one and move forward a little bit. Zhang Fan breathed slowly, and countless exercises in his system had already given him a feeling of breaking through blood vessels. This was obtained in exchange for countless hypoglycemic symptoms, and in exchange for all kinds of mysterious and dizzy conditions. Come.
Not only did the doctor who performed the operation dare not show off his arrogance, but even Professor Li Housen and Professor Yan Dehua, who were watching the operation, did not dare to do so.
Although they couldn't see the specific operation, Professor Li Housen's face turned red when he saw Zhang Fan's super stable hands, and he kept shouting in his heart: "That's it, that's it."
"It's so stable!" The experts in the conference room looked more venomous, and they could see it when they started to suture.
"Yeah, it's too stable. I just don't know how long it will last. This surgery doesn't take more than an hour or two. Hey~!"
At this time, the blood vessels are like two intersecting rubber tubes, one inside the other. The front side is sutured first, and then turned 180 degrees to suture the other side.
Zhang Fan mentioned the adventitia of blood vessels. On blood vessels with a diameter of no more than 1 mm, if the fracture is calculated according to this clock face, it should be sutured first at 12 o'clock, and then at the opposite 6 o'clock.
Take the third stitch at 2 o'clock, the fourth stitch at 4 o'clock, turn over, take the fifth stitch at 8 o'clock, and take the last stitch at 10 o'clock. Each suture has to pass through the blood vessels twice. It is really difficult. It is just like smoking in a gas station. Every time you inhale and exhale, it may explode.
Every time I sewed, I sweated a lot. It was necessary to control the strength, to control the continuous output of strength, and the left and right hands had to cooperate very skillfully. It was really difficult to do something as brittle as the lining of a raw egg. After each stitch, Zhang Fan had to stop and wipe off his sweat to allow his muscles to recover a little bit.
"Glucose!" Zhang Fan felt a little dizzy. It took more than three hours for the skin on his face to reach his chin. After taking a greedy sip of high-concentration glucose, he continued.
Small blood vessels, small nerves, and microscopic lymphatic vessels are each more difficult and complex than the last. If the blood vessels are not sutured, the skin will not survive. If the nerves are not sutured for a little longer, the skin will atrophy. If the lymph nodes are not sutured, there will be endless swelling in the later stage.
What else can I do, liver. Everyone inside and outside the operating room was all on tenterhooks. The more hopeful you are, the more worried you are. The better Zhang Fan performed, the more worried everyone became.
Repair and reconstruct the eye sockets, fit the nasal cavity along the texture, and repair the lips, step by step. Slowly, the bloody face became more acceptable.
"Open the hemostat!" In an instant, the blood entered the allogeneic skin through the repaired pipe, and the originally pale pig skin turned blood-colored.
"How is it?" Professor Li Housen asked quietly with a dry throat, his heart clenched together, feeling so uncomfortable.
"It should be possible." Zhang Fan looked at his masterpiece and said slowly. Although he will not see a bright smile or rich expressions in the future. However, he can walk in the sunshine and face the world happily.
. m.
