小儿腹壁下动脉穿支皮瓣移植修复足踝部软组织缺损的手术配合

Cooperation in the deep inferior epigastric perforator flap for foot and malleolus reconstruction of child

目的探讨小儿腹壁下动脉穿支皮瓣移植修复足踝部软组织缺损的手术配合方法，减少手术相关并发症，以提高手术疗效。方法回顾性分析15例小儿腹壁下动脉穿支皮瓣移植修复足踝部软组织缺损手术配合的情况。结果15例手术顺利完成，手术配合恰当，手术用时缩短，出血明显减少。14例皮瓣术后顺利成活，皮瓣受区与供区创口愈合良好。足踝功能恢复良好。腹部外形恢复较好，腹壁功能无明显影响。结论护理人员充分的术前准备、术中密切的观察和护理及积极主动的手术配合是小儿腹壁下动脉穿支皮瓣移植修复足踝部软组织缺损手术成功的重要保障。

Objective To investigate cooperation care methods of the deep inferior epigastric perforator （DIEP） flap for child＇s foot and malleolus reconstruction, so as to improve the treatment effect and minimize complications. Methods The clinical records on the intraoperative care in the DIEP for foot and malleolus reconstruction of child were retrospectively analyzed. Results All the 15 operations were implemented successfully, the proper intraoperational cooperation shortened the duration of operation and reduced bleeding. Among which, 14 cases of flap transplantation survived well, with the donor-site and the receptor-site primary were well-healed. The patient has obtained the good function of the foot and malleolus. The abdomen contour resumes well, and the abdominal wall competency is preserved. Conclusions The sufficient preoperational preparation, careful intraoperative observation and care, active and effective cooperation of nurse in operation are important for the success of the operation.