144: Chapter 144 presents a risk of permanent facial dysfunction.
Emergency Department treatment room.
Lu Chen pushed the door open and entered.
There were two people in the treatment room.
One was the young doctor on duty, standing to the side, holding a CT report in his hand.
The other was a man sitting on the treatment bed, roughly in his early fifties, with a thin build, wearing a dark-colored stage costume.
His right face was covered with a large, blood-stained gauze, the edges of which were soaked through with oozing blood, dark red in color.
Seeing Section Chief He Zhongfeng bring someone in, he immediately stood up.
"Zhongfeng, who is this?"
Section Chief He Zhongfeng walked over quickly and steadied him.
"Uncle-in-law, this is Dr. Lu Chen from our Hospital Emergency Department. His Suturing technique is the best in the entire Hospital; I specifically asked him to come."
The man looked at Lu Chen, his eyes filled with obvious urgency and anxiety.
"Dr. Lu, hello, hello. I'm sorry to trouble you."
Lu Chen nodded slightly.
"Sit down first. Let me examine the wound."
The man sat back down on the treatment bed.
Lu Chen walked over and first glanced at the CT report in the young doctor's hand.
"No fractures on the facial CT?"
The doctor on duty nodded.
"Right, the zygomatic bone and maxilla are fine. It's just a deep laceration of the soft tissue."
"Have you checked the facial nerve?"
"Checked. The temporal, zygomatic, buccal, and marginal mandibular branches have all been functionally examined. Conduction is normal; the facial nerve is not severed."
Lu Chen took the CT report, looked at it for a moment, and put it down after confirming everything was correct.
"Let me take a look at the wound."
He put on gloves and gently lifted the gauze.
The moment the wound was exposed, Shen Xiaoning, standing nearby, gasped.
The laceration started from the outer corner of the right eye, slanted downwards, and extended all the way to the right side of the mouth.
The entire wound was about eight centimeters long, and the wound edges were, as Section Chief He Zhongfeng described, jagged and uneven.
The skin and subcutaneous tissue were everted, with dark red muscle tissue exposed.
The most shocking part was the middle section, where the wound depth was at least one centimeter.
One could clearly see the severed muscle bundles retracting on both sides of the wound.
The zygomaticus major and levator anguli oris muscles were completely severed.
There was no change in Lu Chen's expression.
His fingers pressed gently on the edges of the wound, feeling the tension and elasticity of the tissue.
Then he activated the Eye of Truth.
[Eye of Truth scan complete]
[Patient information: Male, 52 years old]
[Chief complaint: Right facial laceration caused by prop glass approximately 45 minutes ago]
[Eye of Truth diagnosis: Deep right facial laceration (8.2 cm), involving full-thickness skin, subcutaneous tissue, superficial musculoaponeurotic system (SMAS layer), zygomaticus major (completely severed), levator anguli oris (completely severed), irregular jagged wound edges, complicated by mild tissue contusion]
[Risk level: C (No life-threatening danger, but there is a risk of permanent facial dysfunction)]
[Current symptoms: Active bleeding from the wound, mild wound edema, partial loss of spontaneous facial expression on the right side (inability to lift the right corner of the mouth, loss of activity in the right risorius muscle area)]
[Recommendation: Perform immediate Debridement and Suturing for the deep facial laceration, focusing on precise muscle bundle alignment and anastomosis repair of the zygomaticus major and levator anguli oris, layer-by-layer Suturing of the SMAS layer, subcutaneous tissue, and skin layer; for the skin layer, intradermal continuous cosmetic Suturing is recommended to reduce scar formation]
[Warning: The wound has persisted for 45 minutes, mild edema of the wound edges is in progress; it is recommended to complete the Suturing within 2 hours. After 2 hours, tissue edema and inflammatory response will increase significantly, affecting precise muscle bundle alignment and cosmetic results]
Lu Chen finished reading all the information provided by the system.
Eight point two centimeters, zygomaticus major and levator anguli oris completely severed, irregular wound edges, must be completed within two hours.
Time is sufficient.
Technique is sufficient.
Can do it.
He closed the Eye of Truth interface and turned to look at Section Chief He Zhongfeng and his uncle-in-law.
"I have clearly assessed the wound condition. The facial nerve is fine, but both the zygomaticus major and levator anguli oris are severed."
"It requires precise muscle bundle alignment repair, followed by layered Suturing."
Section Chief He Zhongfeng's uncle-in-law looked at him nervously.
"Dr. Lu, can it be repaired? I have a very important performance at the end of this month. If I can't make facial expressions..."
He didn't finish his sentence, but the fear in his eyes said it all.
Lu Chen looked at him.
"I can do it, but I need to make a few things clear to you."
"Go ahead, please tell me."
"The Suturing process requires local anesthesia. The facial nerves are quite dense, so there might be a brief sensation of facial numbness after anesthesia; this is normal and will subside."
"Okay, okay."
"The recovery period after Suturing is about two to three weeks. During this time, there will be swelling on the face. You cannot make exaggerated facial expressions or chew hard objects forcefully. Whether you can make it to the performance at the end of the month depends on the speed of recovery."
"Two to three weeks? There are over twenty days left until the end of the month. Will that be enough time?"
Lu Chen thought for a moment.
"If the Suturing result is good, it should be in time."
Section Chief He Zhongfeng's uncle-in-law nodded repeatedly.
"Then I'll leave it to you, Dr. Lu. My life—no, my face is in your hands."
Section Chief He Zhongfeng also added from the side.
"Dr. Lu, I really beg of you."
Lu Chen ignored Section Chief He Zhongfeng and turned directly to Shen Xiaoning.
"Help me prepare a Suturing instrument kit, the fine Suturing set. Also, prepare several types of absorbable sutures: 4-0, 5-0, and 6-0 are all needed. For the skin suture, use a 6-0 non-absorbable suture."
"Understood."
Shen Xiaoning immediately ran out to prepare.
Lu Chen glanced at the doctor on duty again.
"Can the shadowless lamp in the treatment room be adjusted to be brighter?"
"Sure, I'll adjust it."
The doctor on duty went to adjust the lights.
Lu Chen returned to the treatment bed.
"First, we will perform Debridement to clean away debris and devitalized tissue from the wound surface, then we will suture."
Section Chief He Zhongfeng's uncle-in-law nodded nervously.
...
Five minutes later, Shen Xiaoning returned carrying the instrument kit and sutures.
Lu Chen checked the instruments; everything was fine.
Hemostatic forceps, mosquito forceps, microsurgical needle holder, microsurgical tweezers, iris scissors—a full set of fine Suturing instruments, plus several types of sutures.
That's enough.
He first performed local infiltration anesthesia around the wound.
Lidocaine with epinephrine, injected in points along the wound edges. His movements were steady and light; Section Chief He Zhongfeng's uncle-in-law barely felt any pain.
"Are you this gentle with injections too?" Section Chief He Zhongfeng's uncle-in-law was a bit surprised.
"There are many facial nerves, one must be careful when inserting the needle."
After the anesthesia took effect, Lu Chen began the Debridement.
He repeatedly irrigated the wound surface with normal saline, cleaning out the broken glass shards, blood clots, and fragments of devitalized tissue bit by bit.
As his fingers explored the wound surface, Shen Xiaoning noticed a detail.
The way his fingertips moved was different from usual.
Usually, when performing routine Debridement, his movements were fast and decisive.
But now, his fingertips were sensing bit by bit, slowly advancing, pausing, and advancing again.
She knew what he was doing.
He was using his fingers to feel the tissue structure beneath the wound surface.
The passive effect of the God-level Suturing Technique, a 25% increase in hand tactile sensitivity, allowed him to perceive tissue layer differences invisible to the naked eye.
He was using his fingers instead of his eyes to explore the direction and retraction position of every severed muscle fiber bundle.