头面部黑色素瘤手术切除并皮瓣修复围手术期护理

Perioperative nursing care of patients with melanoma in the head and face undergoing surgical flresection and flap repair

目的 总结头面部黑色素瘤手术切除并皮瓣修复围手术期护理措施,为临床该类患者护理措施的制定和改进提供参考。方法 检索数据库收集相关文献资料,作为理论支持和参考依据,通过小组讨论和临床改进,最终制定出包括心理护理、术前准备护理、术后疼痛护理、皮瓣及伤口护理、出院指导护理等围手术期护理措施,并实施于2020年6月至2023年1月在本院接受手术切除并皮瓣修复的41例患者。结果 本研究41例患者均顺利完成手术,平均手术时间为(87.07±18.79) min,术后1例发生切口裂开,1例发生血管危象,1例发生感染,经早期积极处理,症状均得到改善和纠正,最终皮瓣存活,随访6个月,无发生肿瘤转移病例;1例产生瘢痕增生,1例切口周围皮肤存在轻度色素沉着;所有患者对护理服务满意度和整形美容满意度均表示满意。结论 早期对头面部黑色素瘤患者实施肿瘤外科切除并皮瓣修复治疗安全性高,预后良好,科学有效的围手术期护理是保证手术顺利完成,提升皮瓣成活率的重要措施,临床应尽早形成规范的围手术期护理,提升专科护理水平。

Objective Summarize the perioperative nursing measures for the removal and flflap repair of melanoma in the head and face,providing reference for the development and improvement of nursing measures for such patients in clinical practice.Methods Retrieve the database and collect relevant literature as theoretical support and reference basis.Through group discussions and clinical improvements,perioperative nursing measures including psychological care,preoperative preparation care,postoperative pain care,flflap and wound care,and discharge guidance care were ultimately developed.These measures were implemented in 41 patients who underwent surgical resection and flap repair in our hospital from June 2020 to January 2023.Results All 41 patients in this study successfully completed the surgery,with an average surgical time of(89.42±20.18)minutes.After the surgery,1 patient experienced incision dehiscence,1 patient developed vascular crisis,and 1 patient developed infection.After early active treatment,symptoms were improved and corrected,and ultimately the flflap survived.After a follow-up of 6 months,there were no cases of tumor metastasis;1 case developed scar hyperplasia,and 1 case had mild pigmentation on the skin around the incision;All patients expressed satisfaction with nursing services and plastic surgery.Conclusion Early surgical resection of tumors and flflap repair for patients with melanoma in the head and face is highly safe and has a good prognosis.Scientifific and effffective perioperative care is an important measure to ensure the smooth completion of the surgery and improve the survival rate of the flflap.In clinical practice,standardized perioperative care should be formed as soon as possible to improve the level of specialized nursing.