皮瓣修复面颊部洞穿性缺损23例围术期护理体会

Experience of perioperative nursing care of 23 cases of perforating check defect repaired with musculotaneous flaps

目的:探讨皮瓣修复面颊部洞穿性缺损患者围术期的护理方法。方法:对23例面颊部洞穿性缺损患者,采用胸大肌皮瓣、腓骨肌皮瓣、前臂皮瓣、背阔肌皮瓣单独或联合修复,术前给予心理指导及针对性训练,术后密切观察病情,预防血管危象的发生,预防感染,加强营养支持。结果:4例采用胸大肌皮瓣修复的患者术后出现部分液化坏死,经换药创面愈合,23例均顺利出院。结论:对面颊部洞穿性缺损皮瓣修复患者,术前给予心理指导及针对性训练,术后预防血管危象的发生,预防感染,加强营养支持是保证手术成功的关键。

Objective: To explore the methods of nursing care in perioperative period in the treatment of perforating check defect repaired with musculotaneous flaps.Methods: Single or combined repairs were applied to 23 cases of perforating check defect with pectoralis major myocutaneous flap,free fibula osteomyocutaneous flap,free radical forearm flap and latissimus dorsi flap.Corresponding nursing care were taken before and after the operation in order to prevent from flap vessel crisis,infection and to ensure the survival of transplanted flaps.Results: Four cases repaired with pectoralis major myocutaneous flap got necrosis in local regions and healed up through treatment.All 23 patients were cured and discharged from hospital.Conclusion: Psychological nursing and training before operation,sustaining nourishment and preventing from flap vessel crisis and infection are the keys to the successful transplantation of flaps.