Abstract:

This article summarized the perioperative nursing experience of 21 patients with free anterolateral femoral perforating flap in repairing deep ulcer of limbs caused by cobra injury. Nursing key points included：before surgery,adequate wound preparation,ultrasound positioning of blood vessels in the donor site,and effective closed drainage with negative pressure,and psychological care;during surgery,pay attention to temperature monitoring and blood pressure control,accurately cooperate for anastomosis of arteries and veins,and prevention of intraoperative arterial crisis;after surgery,pay attention to nursing care of skin flaps,observation of blood supply of flaps,prevention and timely management of vascular crisis of flaps,regulated usage of sensitive antibiotics during all procedures,and early rehabilitation training. There were no necrosis or partial necrosis of the skin flap in 21 patients.Perioperative precise nursing is an important guarantee for the success of free anterolateral femoral perforating flap in repairing the deep ulcer of limbs caused by cobra injury.

Key words: Surgical Flaps, Free Tissue Flaps, Snake Bites, Skin Ulcer, Perioperative Nursing

摘要：

总结21例游离股前外侧穿支皮瓣修复眼镜蛇咬伤致四肢深层溃疡患者围术期的护理经验。护理要点：术前进行创面准备、负压封闭引流、皮瓣供区血管超声定位及心理护理;术中防止出现低体温,维持控制性低血压,做好血管吻合环节管理,预防术中动脉危象;术后做好皮瓣护理,密切观察皮瓣血液循环,预防和及时处理皮瓣血管危象,全程规范使用敏感抗生素及指导早期康复训练。本组21例患者皮瓣全部成活,皮瓣均未出现坏死或部分坏死。围手术期的精准护理是游离股前外侧穿支皮瓣修复眼镜蛇伤致四肢深层溃疡治疗成功的重要保证。

关键词: 外科皮瓣, 游离组织瓣, 蛇咬伤, 皮肤溃疡, 围手术期护理