腹部带蒂皮瓣修复手部深度烧伤的围手术期护理

Perioperative nursing for abdominal pedicled skin flaps for repairing deep burn in hands

目的探讨完整的腹部带蒂皮瓣修复手部深度烧伤围手术期护理程序。方法对48例采用腹部带蒂皮瓣手术修复手部深度烧伤的患者进行全方位的护理进行总结，包括术前疾病评估、配合清创换药、心理护理、体位和皮肤准备，感染控制，术后疼痛护理、皮瓣观察、体位护理、并发症防治、功能锻炼、康复指导等。结果48例患者腹部皮瓣移植成活，供瓣区受瓣区均生长良好。出院后3—6个月追踪，除3例术前神经血管指骨严重毁损功能丧失外，其余病例手部日常功能恢复良好。结论采用全方位多学科护理知识科学护理是腹部带蒂皮瓣修复手部深度烧伤患者的有力保障，以确保手术成功、肢体功能恢复、生活质量提高、社会生存能力增强。

Objective To explore to build up a complete set of care program for patients underwent abdominal pedicled skin flaps for repairing deep burn in hands. Methods Omnidirecional nursing including preoperative assessment, cooperation with debridement and dressing change, mental nursing, body position and skin provision, infection control, postoperative pain nursing, observation of flap circulation, position nursing, prevention of complications, functional exercise, rehabilitation instruction were used in the reconstruction of shallow defects in 48 patients underwent abdominal pedicled skin flaps for repairing deep burn in hands. Then the nursing was summarized. Results The abdominal flap transplantation successed in all of the 48 cases. The donor site of flap and the receptor site of flap growed well. The mean postoperative follow-up period was 3 -6 months, and the satisfactory improvement in hand function was obtained in all patients except for 3 cases suffered from postoperative sever injury and loss of function of nettrovascular phalange. Conclusions Omnidirectional nursing can ensure the success of operation, the recovery of limb function, the improvement of life quality and the enhancement of living ability for patients underwent abdominal pedicled skin flaps for repairing deep burn in hands.