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1、穿支皮瓣修复手足部创面的术后护理董翠明(商丘市第一人民医院分院,手足外二病区河南商丘476100)【摘要】目的:研究分析穿支皮瓣修复手足部创面的术后护理对策。方法:选取我院2012年11月-2014年11月收治的手足部软组织缺损行穿支皮瓣修复术患者60例,所有患者均给予有效、全面、针对性的术后护理,主要内容包括密切观察患者皮瓣血运以及疼痛护理、药物护理、并发症护理等。结果:所有患者中,3例修复足部皮瓣远端足底反叠边缘出现少许坏死,换药后瘢痕愈合;2例患者术后1周发生创面局部感染,通过据不拆线引流,给予敏感抗生素
2、及换药处理后愈合。随访1年,所有皮瓣均完全成活,皮瓣色泽红润,皮肤组织弹性较好,外形满意,未出现溃疡和严重瘢痕挛缩。结论:密切观察患者病情变化,给予及时的处理措施和针对性疼痛护理、药物护理、并发症护理能够有效促进患者创面愈合,降低并发症发生率,值得推广。【关键词】穿支皮瓣修复;手足部创面;术后护理【中图分类号】R2【文献标号】A【文章编号】2095-9753(2015)08-0022-02Perforatorsflaptorepairthewoundofhand,footandpostoperativenurs
3、ingDongCuiming(shangqiufirstpeople'shospitalbranch,brotherstwowardHenanshangqiu,476100)[abstract]:objective:tostudytheanalysisofperforatorsflaptorepairthewoundofhand,footandpostoperativenursingcountermeasures.Selectionmethods:ourhospitalinNovember2012-Novemb
4、er2014footsofttissuedefectinthelineof60patientswithperforatorsflaprepair,allpatientsweregivenpostoperativenursingcareofeffectiveandcomprehensive,targeted,mainlyincludestheskinflapbloodsupplywereobservedcloselyandpainnursing,medicationnursing,complicationnurs
5、ing,etc.Results:allpatients,3casesofrepairdistalplantarfootflapthefoldedgeappearsalittlenecrosis,scarhealingafterdressingchange;Localinfectionoccurredin2patientsinpostoperative1weekwounds,throughaccordingtonotremovethedrainage,sensitiveantibioticsandhealinga
6、ftertreatmentprocess.Follow-upof1year,allflapssurvivedcompletely,flap,colourandlustreisruddyskintissuehasgoodelasticity,satisfactoryappearance,doesnotappearulcerandseverescarcontracture.Conclusion:closeobservationofpatients,givetimelytreatmentandpainnursing,
7、medicationnursing,complicationnursingcaneffectivelypromotepatientswithwoundhealing,reducetheincidenceofcomplications,worthyofpromotion.Keywords:perforatorsflap;Footwound;Postoperativenursing伴随皮瓣外科技术的不断进步和完善,其对于美观和功能有了更高要求。穿支皮瓣主要是通过切取薄皮瓣减轻患者功能障碍,0前已被广泛运用于临床[1
8、]。研究显示[2],穿支皮瓣具奋以下优势:(1)不切取肌肉,对运用功能无影响;(2)可根据受区需要切取;(3)对供区损伤较小,不影响供区外观;(4)术后恢复快,减少并发症发生[3】。然而穿支血管较为纤细,极易发生术后血管危象,临床认为给予有效的术后护理能够有效促进患者恢复,降低并发症发生率[4]。本次研宄选取我院收治的手足部软组织缺损行穿支皮瓣修复术患者给予全面、系统、针对性术后护理,