前臂皮瓣修复手指手掌软组织缺损的围手术期护理  

Perioperative nursing care of forearm flap in repairing soft tissue defect of fingers and palms

作　　者：康晓冉 秦争艳[1] 韩志新 KANG Xiao-ran;QIN Zheng-yan;HAN Zhi-xin(Anyang People's Hospital,Henan Province,455000,China)

机构地区：[1]安阳市人民医院,河南安阳455000

出　　处：《中国医疗美容》2021年第5期87-90,共4页China Medical Cosmetology

摘　　要：目的分析与探讨手指手掌软组织缺损行前臂皮瓣修复的围手术期护理干预方法与效果。方法:选取2017年5月~2020年6月在本院接受修复治疗的30例手指手掌软组织缺损患者,18例患者选择前臂随意皮瓣修复,7例患者选择前臂皮管修复,5例患者选择前臂轴型皮瓣修复。总结上述患者的围手术护理及效果。结果本组30例中29例移植皮瓣顺利I期成活,1例由于存在明显污染情况,不具有较强的自控力,未严格遵照医嘱吸烟,造成皮瓣部分成活,经采取II期扩创,认真讲解吸烟所导致的严重后果,局部换药14天后未见皮瓣存在不成活情况。前臂供皮区全部I期愈合,未见感染情况。经功能训练、术后90天的随诊,皮瓣外形、血供满意,基本不会对正常工作和生活产生明显影响。结论在选择前臂皮瓣修复患者手指手掌软组织缺损过程中,对患者做好围手术期护理干预,特别是有效的基础护理、心理护理和密切观察患者皮瓣血运情况,避免患者出现动静脉危象,是确保前臂皮瓣修复手术成功的重要条件。Objective To analyze and discuss the perioperative nursing intervention methods and effects of forearm skin flap repair for soft tissue defect of fingers and palms.Selection Methods In May 2017-June 2020 in our hospital treated with repair of 30 patients with finger palm soft tissue defect of forearm free skin flap to repair,18 patients,7 patients choose forearm hose repair,choose skin flap repair with forearm shaft,5 patients during the surgery,effective nursing intervention on the patients.Results A total of 29 cases smoothly stage I transplanted tisssues survived,1 case because of the obvious pollution,do not have strong self-control,not strictly follow the doctor’s advice,smoking cause part flap survival,the phase II debridement,explanation by the serious consequences caused by smoking,partial treatment is 14 days did not see flap survival situation.All the donor sites of the forearm healed in stage I without infection.After functional training and follow-up 90 days after surgery,the shape and blood supply of the flap were satisfactory,and there was no obvious effect on normal work and life.Conclusion The study showed that patients with forearm skin flap to repair finger palm soft tissue defect in the process,completes the perioperative nursing intervention on the patients,especially the effective basic nursing,psychological nursing and close observation of patients with skin flap blood supply situation,avoid patients in arteriovenous crisis,is one of the important conditions to ensure the success of the forearm flap surgery to repair.

关 键 词：手指手掌 软组织缺损 前臂 皮瓣修复 护理 

分 类 号：R473.6[医药卫生—护理学]