轴型皮瓣与游离皮瓣在小腿创伤应用中的护理

目的探讨小腿创伤中严重的皮肤及软组织缺损应用带蒂轴型皮瓣与游离皮瓣修复的护理。方法认真做好术前皮肤准备、体位训练、戒烟宣教；术后做好体位放置、监测生命体征、及时有效处理皮瓣血管危象。结果216例皮瓣中，16例发生静脉危象，10例发生动脉危象，经过处理，其中5例边缘部分坏死，211例完全成活。结论正确有效的术前、术后护理是保证带蒂轴型皮瓣与游离皮瓣手术效果的关键，可提高手术成功率。

Nursing for the applications of axial flap and free flap for the leg wound treatment

Objective To study the nursing of the serious skin defect and soft tissue defects repaired with pedicled axial flap and free flap for keg trauma. Method Pre-operative nursing, such as providing careful psychological care, preparing involved skin area, training correct body position and advising patients to give up smoking was conducted for patients. After operation it includes placing body position correctly, observing any change in vital signs and dealing with vascular crisis of the flap effectively and in time. Result Among 216 patients, sixteen had venous crisis and ten had arterial crises of the flaps. After treatment, five appeared maginal necrosis and 211＂cases＂ flaps survived completely. Conclusion Correct and effective pre-operation nursing and postoperation nursing can ensure success in both pedicled axial flap and free flap operation, The success rate of surgery was 97.7%.