摘要
目的：总结逆行拇桡侧指背动脉筋膜蒂掌骨皮瓣修复拇指末节复合组织缺损围术期的护理措施。方法选取12例逆行拇桡侧指背动脉筋膜蒂掌骨皮瓣修复拇指末节复合组织缺损患者做好术前心理护理﹑健康教育﹑供受区皮肤准备等。术后详细了解手术经过，特别强调该骨皮瓣血供观察与普通皮瓣观察的区别，密切观察皮瓣的颜色﹑温度﹑张力﹑毛细血管充盈时间，卧位适当，病室环境适宜，保持患者良好心情，后期加强正确的康复指导。结果本组患者中仅1例术后发生静脉危象，经护士及时观察发现，汇报医生拆除部分缝线加强换药积极处理后皮瓣成活，其余11例逆行拇桡侧指背动脉筋膜蒂掌骨皮瓣均顺利成活。所有患者均为Ⅰ期愈合，未见皮肤溃疡、磨损等情况，拇指关节功能恢复至正常水平，无一例发生并发症。结论依据拇桡侧指背动脉筋膜蒂掌骨皮瓣血运的特点开展全面的围术期护理，可有效判断血管危象的实际发生情况，进而提高骨皮瓣移植成活率，具有确切的应用价值。
Objective To study and summarize nursing measures for repairing the thumb details composite tissue defects with ret-rograde dorsal thumb radial side referring to the artery fascia pedicle metacarpal flap.Methods A total of 12 cases of patients were selected and treated with good preoperative psychological nursing, health education, for the areas of skin preparation and so on.After operation, the difference between this blood supply of bone flap and ordinary flap was compared.To closely observe the color of the skin flap, temperature, tension, capillary filling time, decubitus, and to keep appropriate ward environment, the patients＆39;good mood, to strengthen the correct guid-ance late period.Results The patients in this group only 1 case of postoperative venous crisis occurred, then the nurse observed and found in time, the doctor removed some stitches to strengthen positive processing, skin flap survived.All of the patients were stageⅠhealing, no skin ulcer, wear etc., the thumb joint function recovers to normal levels, no complications occurred.Conclusions Carrying out compre-hensive perioperative nursing measures can effectively judge the vascular crisis actually happened, and enhance the survival rate of bone flap transplantation, has definite application value.
出处
《国际护理学杂志》
2015年第5期705-707,共3页
international journal of nursing
关键词
骨折
拇指
软组织损伤
护理
Fracture
Thumb
Soft tissue injury
Nursing
