58例穿支蒂螺旋桨皮瓣修复足踝部软组织缺损的护理

Perioperative nursing of 58 patients undergoing foot and ankle soft tissue repairment with perforator-based propeller flaps

总结了58例穿支蒂螺旋桨皮瓣修复足踝部软组织缺损患者的护理。护理重点包括完善术前准备,做好有效沟通,术后做好持续负压引流、体位管理、血管危象及其他合并症的观察和护理。本组术后出现静脉危象8例,伴动脉危象2例,深部感染1例,最终3例皮瓣远端1/3坏死,2例供髂骨区感染,1例供区皮肤愈合不佳,均经清创和对症处理后治愈。

This paper summarizes the perioperative nursing of 58 cases undergoing foot and ankle soft tissue repairment with perforator-based propeller flaps. The key points in nursing were preoperative preparation and patient education,postoperative vacuum drainage,position care,observation and treatment of vessel crisis and other complications. Eight patients suffered from venous crisis, two of them were complicated by artery crisis ,and one patient suffered from deep infection. At last,necrosis of the distal part of the flap was identified in three patients,infection in the donor area of iliae in two patients and partially necrosis of the donor area in one patient. All patients were cured after debridement and wound dressing change.