游离皮瓣眶窝再造术患者的术后护理

Postoperative Nursing of Eye Socket Reconstruction with Free Flap

目的总结分析游离皮瓣眶窝再造术后的护理要点。方法26例眶窝凹陷及眼窝闭锁患者接受游离皮瓣移植,其中24例采用前臂游离皮瓣,2例采用肩胛皮瓣。术后定时观察皮瓣的色泽、质地、温度、充盈情况以及肿胀情况,必要时可行多普勒仪检查。同时观察血管吻合部位伤口引流量的大小及引流物的颜色,前臂皮瓣游离移植患者还须观察指端末端血液循环情况。结果26例患者所有眶窝内移植的皮瓣均成活,未出现坏死或感染,外观满意,义眼配戴良好。结论游离皮瓣眶窝再造术后的精心护理对于手术成功及患者恢复至关重要。

Objective To analysis the key points of postoperative nursing of eye socket reconstruction with free flap.Methods Free flap was used in 26 patients with contracted eye socket and anophthalmos.The forearm free flap was utilized in 24 cases,the scapular flap in 2 cases.The colour,texture,temperature and swelling of the flaps were observed postoperatively and regularly.The Dopolar examination was another choice when necessarily.The volume and colour of drainage of the wound where the microvascular anastomoses was undergwent were surveyed simultaneously.The blood circulation of the finger tip was observed in the patiens of the forearm free flap transfer.Results The flaps were transferred successfully in all patients.The better cosmetic results were achieved and the well fitted eye prosthesis was weared.Conclusion The careful postoperative nursing of eye socket reconstruction with free flap played a vital role for the success of the operation.