游离足第二趾侧方分裂皮瓣修复手指皮肤的护理

Nursing Care of Repairing Finger Skin With Free Second Toe Split Flap

目的总结15例游离足第二趾侧方分裂皮瓣修复多个手指皮肤软组织缺损的临床护理经验。方法 2015年12月—2017年3月,我科15例34指皮肤缺损患者采用游离足第二趾侧方分裂皮瓣修复创面。术前进行充分的准备及术后护理重点围绕游离皮瓣血运展开,分析血运变化特点及处理方法,同时加强心理护理、镇痛护理、并发症的预防及功能康复等护理措施。结果本组15例34指皮瓣全部成活。有3指皮瓣出现血管危象,均在护理观察中及时发现并汇报医生,通过对症处理或手术探查后缓解。结论游离足第二趾侧方分裂皮瓣修复多个手指皮肤缺损临床效果满意,根据皮瓣特点开展全面护理,尤其是皮瓣移植术后血管危象的早期观察及针对性护理,是提高皮瓣成活的关键。

Objective To summarize the clinical nursing experience of 15 cases of free lateral split flap of second toe to repair multiple finger skinsoft tissue defects.Methods From December 2015 to March 2017,15 patients with 34 finger skin defects in our department were treated with free lateral split flap of second toe to repair the wound.Full preoperative preparation and post-operative nursing focused on the blood supply of free flaps.The characteristics and treatment methods of blood supply change were analyzed.At the same time,psychological nursing,analgesic nursing,prevention of complications and functional rehabilitation nursing measures should be strengthened.Results All of the 34 finger in this group survived.There were 3 finger of vascular crisis in the flaps,which were found in the nursing observation and reported to the doctor in time,and relieved by symptomatic treatment or surgical exploration.Conclusion The clinical outcome of repairing multiple finger skin defects with the free lateral split flap of second toe is satisfactory.According to the characteristics of the flap,comprehensive nursing,especially the early observation and targeted nursing of vascular crisis after flap transplantation,is the key to survival of the flap.