骨间背动脉逆行岛状皮瓣修复手部机器绞伤皮肤缺损的护理

目的：探讨骨间背侧动脉逆行岛状皮瓣修复手外伤皮肤缺损围手术期的护理方法，总结护理经验，提高护理质量。方法对13例机器绞伤先期行清创、VSD负压吸引术，后期行骨间背动脉逆行岛状皮瓣的患者进行综合护理干预，包括注重心理护理、加强基础护理、术后控制感染、严密观察血管危象、指导功能训练、重视出院指导等。结果13例患者皮瓣血运良好，全部成活。结论骨间背侧动脉逆行岛状皮瓣修复手外伤皮肤缺损疗效满意，根据皮瓣血运的特点开展全面的围术期护理，可有效判断血管危象的实际发生情况，进而提高皮瓣移植成活率。

Interosseous dorsal artery retrograde island flap to repair hand machine and nursing care of skin defect

Objective In order to summarize the nursing experiences and improve nursing quality,we explore the perioperative nursing methods in patients reconstructing skin defects with posterior interosseous artery flaps. Methods The 13 patients with skin defects were treated with debridements and vacuum sealing drainage system,and then the skin defects were covered with posterior interosseous artery flaps. In the perioperative period,we give united nursing interven-tion to the patients,including basic nursing,psychological nursing,controlling infection,carefully observing the vascular crisis,instructing exercise,and discharge guidance. Results All the 13 flaps survive well. Conclusion The effects of posterior interosseous artery flaps covering skin defects of hand is well. Based on the characteristics of the blood supply of this flap,we carry out comprehensive perioperative nursing,and can judge the occurance of vascular crisis effectively. United nursing intervention is effective in improving the surviving rate of the posterior interosseous artery flap.