游离皮瓣治疗下肢软组织缺损的围手术期护理

目的:观察25例游离皮瓣移植修复下肢软组织缺损的临床疗效.方法:6例患者用股前外侧皮瓣,19例用背阔肌皮瓣,修复下肢软组织缺损,经术前及术后的基础及专业护理,术后严密观察记录移植皮瓣的血液循环情况.结果:14例移植皮瓣成活良好,创口一期愈合.11例发生血管危象,5例行手术探查重新吻合血管,4例成活,1例坏死.结论:游离皮瓣移植术能修复下肢严重软组织缺损.术后综合有效的观察和护理可以早期发现和及时处理血管危象,这是皮瓣顺利成活的重要保证.

Perioperative nursing in treating lower limb soft tissue defects by free flap

Objective：To summarize the observation and nursing experience in 25 cases of free flap transplantation to repair soft tissue defects in lower limb.Methods：In 6 patients accessing the anterolateral thigh flap,19 cases accessing latissimus dorsi muscle flap to repair soft tissue defects of lower extremities,after pre-and postoperative basic and professional care,close monitoring and recording transplanted flap blood circulation were adopted.Results：The transplanted flap survived well in 14 cases with I stage healing.Vascular crisis occurred in 11 cases,surgical exploration for re-inosculation of blood vessels in 5 cases,flaps were survived in 4 cases and necrosed in 1 case.Conclusion：The free flap graft can repair serious soft tissue defect of lower limb.Postoperative observation and care of comprehensive and effective can early discover and timely treat vascular crisis,which is an important guarantee for flap survival smoothly.