隆突性皮肤纤维肉瘤扩大切除及皮瓣修复术的护理配合

Perioperative Care of 53 Patients Undergoing Expanded Resection and Flap Reconstruction for Dermatofibrosarcoma Protuberans

目的:探讨隆突性皮肤纤维肉瘤扩大切除及皮瓣修复术的护理方法。方法:对53例隆突性皮肤纤维肉瘤患者进行扩大切除及皮瓣修复术的护理。护理措施包括做好术前准备,术后加强对体位和低负压引流的管理,做好移植皮瓣血管危象和切口感染等并发症的护理,以及提供心理支持和出院指导。结果:52例患者皮瓣完全成活,1例因感染皮瓣坏死,经再次植皮,皮瓣愈合良好。术后4~12月门诊随访,52例未见肿瘤复发和转移,功能和外观保持良好,1例于术后半年复发但无转移。结论:良好的护理措施是隆突性皮肤纤维肉瘤行扩大切除及皮瓣修复术成功的重要保障。

Objective To investigate the nursing methods of dermatofibrosarcoma protuberans and underwent expanded resection and flap reconstruction （i.e. Mohs micrographic surgery）. Methods Nursing about 53 patients who had dermatofibrosarcoma protuberans and underwent expanded resection and flap reconstruction. Key measures included good preoperative preparation, maintenance of postoperative position and low negative pressure drainage, management of vascular crisis, surgical site infection and other complications, along with psychological support and discharge instructions. Results 52 patients＇ skin flaps completely survived; one case presented skin flap necrosis due to infection, but the flap healed well eventually after another skin grafting. In a follow-up visit of these patients ,no tumor recurrence and metastasis were seen in 52 patients while 1 patient had a tumor recurrence without metastasis. Conclusion Good nursing measures play an important role on the success of underwent expanded resection and flap reconstruction in dermatofibrosarcoma protuberans.