前臂扩张皮瓣预制耳再造术的围术期护理

Ear Reconstruction with Expanded Forearm Flap Prelamination

目的:探讨前臂游离皮瓣耳部重建的护理措施。方法:1例耳部缺损患者因右侧头面部皮肤软组织损伤严重,耳周皮肤条件差,无法行常规耳再造手术,在笔者医院行前臂预制游离皮瓣耳重建,手术分前臂皮瓣扩张、前臂耳廓预制和耳廓移植三个阶段。围术期制定并实施了详细的护理计划,包括术前心理状况评估与护理、前臂皮肤扩张管理与护理、预制耳廓的护理、软骨采集供体部位的护理、预制耳廓的显微外科移植护理。结果:再造耳结构清晰、生动,围术期无并发症发生,患者及家属对治疗效果及护理满意。结论:除外科医生的医学知识和手术技巧外,预制游离前臂皮瓣耳部重建的效果与围术期护理及患者家属的密切配合有关。

Objective To discuss the nursing measures for reconstruction of auricular reconstruction with forearm free flap.Methods One case of auricular defect was treated with prefabricated free forearm flap for auricular reconstruction because of severe skin and soft tissue injury on the right side of the head and face and poor skin condition around the ear.The surgery had 3 stages:forearm flap expansion,auricle prefabrication on forearm and the prefabricated auricle transplantation.We planned a detailed nursing care project for this surgery,including preoperative psychological condition assessment and nursing,forearm skin expansion management and nursing,nursing for the prefabricated auricle and donor site for cartilage harvest,microsurgical transplantation for the prefabricated auricle’s nursing.Results The structure of the reconstructed ear was clear and vivid.No complications occurred during the perioperative period.The patients and their families were satisfied with the therapeutic effect and nursing care.Conclusion Besides the Surgeon’s medical knowledge and surgical skill,the outcome of ear reconstruction with prefabricated free forearm flap was related to the perioperative period nursing care and the corporation of the patient and family member.