基于加速康复外科理念的集束化护理模式对游离穿支皮瓣修复上肢创面患者疾病预后的影响

The impact of a bundled nursing model based on the concept of accelerated rehabilitation surgery on the disease prognosis of patients undergoing free perforator flap repair of upper limb wounds

目的研究基于加速康复外科理念的集束化护理模式对游离穿支皮瓣修复上肢创面患者疾病预后的影响。方法回顾性分析2020年3月~2022年11月于南阳市中心医院骨科接受游离穿支皮瓣修复上肢创面患者48例。根据入院时间不同分为对照组和试验组,对照组(24例)入院时间为2020年3月~2021年6月采用常规护理,试验组(24例)入院时间为2021年7月~2022年11月采用加速康复外科理念的集束化护理。分析两组患者术后创面愈合时间、住院时间、疼痛程度、修复效果、术后并发症、患者满意度。结果试验组患者创面愈合时间和住院时间、术后6h、24h、36h、72hNRS得分、术后1月VSS总分及各项评分以及术后并发症发生率均低于对照组,试验组患者满意度高于对照组,差异有统计学意义(P﹤0.05)。结论在游离穿支皮瓣修复上肢创面患者应用基于加速康复外科理念的集束化护理模式可以缩短患者术后创面愈合时间和住院时间、缓解疼痛程度、提高修复效果和患者满意度、降低术后并发症。

Objective To investigate the impact of a bundled nursing model based on the concept of accelerated rehabilitation surgery on the disease prognosis of patients undergoing free perforator flap repair of upper limb wounds.Method A retrospective analysis was conducted on 48 patients who underwent free perforator skin flap repair of upper limb wounds at the Orthopedics Department of Nanyang Central Hospital from March 2020 to November 2022.According to different admission times,the control group(24 cases)was divided into a control group and an experimental group.The control group(24 cases)was admitted from March 2020 to June 2021 using routine nursing,while the experimental group(24 cases)was admitted from July 2021 to November 2022 using bundled nursing with the concept of accelerated rehabilitation surgery.Analyze the postoperative wound healing time,hospital stay,pain level,repair effect,postoperative complications,and patient satisfaction of two groups of patients.Results The wound healing time and hospitalization time,postoperative NRS scores at 6h,24h,36h,and 72h,postoperative VSS total score and various scores at 1 month,as well as the incidence of postoperative complications in the experimental group were lower than those in the control group.The satisfaction of the experimental group patients was higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusion The application of a bundled nursing model based on the concept of accelerated rehabilitation surgery in the repair of upper limb wounds with free perforator skin flaps can shorten the postoperative wound healing time and hospital stay,alleviate pain,improve repair effectiveness and patient satisfaction,and reduce postoperative complications.