From small clinic to medical empire

Chapter 57 Beyond 100%

As the outpatient department expands, so does its asset and equipment.

Zhang Zifan felt that it was really necessary to hire a security guard. Otherwise, if a thief came over one night and dismantled his precious equipment and sold it as scrap, it would be too late for Zhang Zifan to cry.

In this case, Zhang Zifan gave up his plan to hire the old man and instead recruited fighting expert Li Jingwang.

This is a mutually beneficial approach, and of course Li Jingwang would not disagree.

After completing the relevant procedures, Li Jingwang paid a surgical fee of 1 yuan.

Since there is no surgical partner at hand, Zhang Zifan still called Yuan Qiang to help. The two have completed dozens of operations together, and they cooperated very well.

It's just that Yuan Qiang only stayed in the surgery and emergency departments for two months when he rotated in the internship hospital before, and he had relatively little experience in general surgery.

General anesthesia is not required for outpatient surgery, and the patient remains conscious after the epidural.

Li Jingwang was lying on the operating bed like a brown bear.

However, he is a person who knows the right thing and the right thing. He obeyed Zhang Zifan's request and worked hard to cooperate with the operation process.

After opening the fascia on the medial edge of the Achilles tendon, Zhang Zifan knew that his judgment was correct. Li Jingwang's ruptured Achilles tendon was full of scars and adhesions.

Probably feeling the solemnity of the atmosphere, Li Jingwang, who was lying on the side, said: "Doctor Zhang, oh no, Director Zhang, try your best, I know my Achilles tendon has been crippled! Liu Xiang is the world champion, and I have invited so many people." The experts are not recovering well either, I am a common man, admit it!"

"You don't have to think too much, I will try to improve the function of your Achilles tendon."

Zhang Zifan turned to Shi Xiaoya and said, "Push the microscope over."

Zhang Zifan did not expect that the surgical microscope he got out of the box a few days ago would come in handy so quickly. The microscopic dissection of the aponeurosis can be more accurate with the help of the microscope.

Due to the strong elasticity of the muscle, it will cause an upward force on the broken Achilles tendon.

After a long time, it is difficult to pull down the broken Achilles tendon.

At this time, other methods have to be used to repair, and the effect is far less than that of immediate treatment after injury.

Traditional aponeurotic flap repairs use the Achilles tendon itself to repair the Achilles tendon, which requires long-distance dissection of the Achilles tendon.

Theoretically, if the Achilles tendon can be perfectly dissected, then the ideal surgical effect can be achieved.

But there are too many uncertain factors in such a long-distance anatomy.

It is extremely easy to damage the blood vessels in the mesotendinosum, resulting in a lack of nutrition for the Achilles tendon.

In addition, a large amount of scar tissue near Li Jingwang's Achilles tendon made the operation more difficult.

At present, the medical community generally takes a different approach to surgery for such old Achilles tendon ruptures.

That is to use the thumb tendon or plantar tendon to repair the Achilles tendon injury.

However, as we all know, the Achilles tendon is the strongest tendon in the human body, and other tissues are insufficient in terms of performance.

After such repair, it may be able to meet the needs of ordinary daily life, but for a fighter, such an Achilles tendon is still too fragile.

[Preset: Aponeurotic flap repair

Prognosis: If the operation is completed perfectly, the recovery rate can reach 83%]

[Preset: plantaris tendon repair surgery

Prognosis: If the operation is completed perfectly, the recovery rate can reach 47%]

Looking at the results of [Eye of Preset], Zhang Zifan showed such an expression under the mask.

After simple thinking, or in other words, deduction with common sense, Zhang Zifan imagined that if the Achilles tendon itself could be perfectly dissected, and then the plantar tendon was used as reinforcement, would it be possible to achieve better curative effect?
[Preset: joint reinforcement of Achilles tendon and plantaris tendon

Prognosis: If the operation is completed perfectly, the recovery rate can reach 130%]

130%?

Zhang Zifan was stunned, this was the first time he saw a situation where the theoretical recovery rate exceeded [-]%.

But then I thought about it and realized it.

The plantaris, also known as the plantar muscle, is actually a degenerative muscle, and even about [-]% of modern people do not have this muscle at all.

Therefore, it is undoubtedly feasible and cost-effective to sacrifice the tendon of the plantar muscle to strengthen the Achilles tendon, which is extremely important for jumping sports.

As for the Achilles tendon itself, it may even be stronger than before after surgery.

Of course, this is all based on precise tissue anatomy.

however……

What is Zhang Zifan’s biggest cheat compared to ordinary surgeons?
It is not a whiteboard microscope that slightly increases the accuracy of surgery under the microscope, or even the [Preset Eye] that has repeatedly made military exploits, but the tissue identification function that comes with the system itself.

Just like in the process of filling a tooth, Zhang Zifan can clearly distinguish infected teeth from healthy teeth and see red and green markings. At this time, looking at the patient's mesotenon, Zhang Zifan seems to see a clear book anatomical atlas.

Where are the inflammatory tissues, where are the old scars, and where are the important anatomical structures, all at a glance!
Now that the exam has been opened, Zhang Zifan naturally cannot get a low score.

At this time, the minimally invasive surgical skills developed through years of neck dissection and lymph node dissection come into play.

The difficulty of long-distance Achilles tendon anatomy has been solved by the system's labeling function, and the rest of the technical requirements are not too difficult for a maxillofacial surgeon with A-ability.

Even so, Zhang Zifan was still extremely careful.

First, he removed the remaining sutures from surgery three years ago.

Naturally, no absorbable sutures are used for Achilles tendon suturing. The previous black tendon suture line has been wrapped in inflammatory granulation tissue, but this cannot escape Zhang Zifan's eyes.

Remove old sutures, remove scar adhesions, bypass the sural nerve and find the plantaris tendon.

Although the plantaris tendon is slender, it belongs to the same tendinous tissue as the Achilles tendon, and there is no significant histological difference in its collagen fiber content.

After dissecting the Achilles tendon perfectly, Zhang Zifan took out the plantaris tendon and woven and sutured it to enhance their strength, and finally sutured continuously through the Achilles tendon according to the Kesslier method.

Multiple plantaris tendons surround the main body of the Achilles tendon like vines, but the vines will strangle the tree, while the plantaris tendon will slowly merge with the main body of the Achilles tendon into a bundle, becoming extremely strong.

Finally, the immobilization of the lower limbs.

In theory, the use of polymer materials will be more comfortable and lightweight.

However, Zhang Zifan understood Li Jingwang's financial situation, so he chose to use a plaster to externally fix his knee in the plantar flexion position.

[Ding, congratulations, congratulations on completing a complex Achilles tendon repair, your surgical skills have improved]

[Ding, congratulations on getting the item: a blueprint of the primary sports rehabilitation room]

Drawings again?

Zhang Zifan was taken aback?

The previous guard room hadn't been found yet, so I didn't expect to get another blueprint.

That's right, a medical center has at least a hundred buildings, killing monsters and dropping treasures, and the appearance of architectural drawings is indeed not a small probability event.

It seems that they have to find a way to sell the nearby clothing store.

Zhang Zifan shook his head and did not think about the hospital construction. Instead, he said to Shi Xiaoya:

"Let Aunt Ma and the others clean up the original doctor's duty room. From now on, Li Jingwang will be the security officer of our outpatient department. During this period of time, his legs and feet are inconvenient. Let Aunt Ma and the others take care of him."

"Doctor Zhang, the operation...is the operation complete?" Li Jingwang asked with some belated awareness.

"The plaster is all put on, you said it's not finished yet?" Zhang Zifan laughed.

"Then...the result of the operation..." Li Jingwang asked anxiously.

"If you cooperate well with cultivation, you can probably recover to 115%." Zhang Zifan replied truthfully, this is the final result he saw with the eye of presupposition.

"Oh, that's good, I don't have to be crippled! Haha!"

Li Jingwang was very happy, but he thought that when Zhang Zifan said 115%, he meant returning to 115% of the state two months ago, that is, after the first operation.

However, Zhang Zifan actually refers to the 115% when he was not injured three years ago.

But Zhang Zifan didn't explain too much.

Generally speaking, Achilles tendon repair requires one and a half months before the cast can be removed for functional exercises, and half a year before full recovery can be achieved.

Instead of explaining anything now, let the facts speak for themselves!
(End of this chapter)