Reconstruction of finger I-degree-IV-degree defect
Suitable for finger I degree to IV degree defect. Treatment of diseases: hand trauma, open hand injury Indication Suitable for finger I degree to IV degree defect. Preoperative preparation 1. Establish a good relationship between nurses and patients. Respect each other and trust each other. 2, adjustment support system patients often have some worries after hospitalization, such as worry about the economic burden, worry about work problems, worry about how others see their own fingers. Nursing staff should try their best to get the encouragement and support of their family members, friends, colleagues and leaders, and receive treatment with peace of mind. 3. Create a good medical environment. A good environment is important to normal people and more important to patients. The quiet and clean environment is conducive to the patient's calm mood, watching TV, listening to music, outdoor walks and other activities can distract the patient's attention and reduce the patient's psychological burden. 4. Using cognitive therapy Cognitive therapy is carried out through conversations between nurses and patients. Through communication, patients can understand the meaning of conversation, relevant surgical knowledge, and answer all kinds of patient concerns, so that they can re-recognize and let It puts down all kinds of burdens on the mind. Surgical procedure 1. The finger I degree to IV degree defect can be reconstructed by the second or third toe transplantation method. The right and middle fingers are respectively II degree and I degree defects. 2. Take the incision design of the toe transplantation of the distal toe joint of the bipedal band and the design of the partial defect of the middle finger. 3. Separate the dorsal vein of the toe in the third toe incision of the right foot. The toe is flexed, the extensor tendon is paralyzed, and the toe floor artery and nerve are both sides. The third toe is broken from the proximal interphalangeal joint. The high position cuts the toe, the extensor tendon and the toe-bottom nerve. Except for toe movement and vein connection, the rest of the tissues have been disconnected. 4. Cut the third toe of the left foot by the aforementioned method. 5, right and middle finger incision design. Cut the skin as designed and find the dorsal vein, the intrinsic artery and the nerve. Loosen and stretch, flexor tendon. Bite the phalanx stump to harden the bone. 6. The bilateral third toe cuts the vascular pedicle to the receiving area. Use a Kirschner wire to penetrate the toe and phalanx for internal fixation. Suture the periosteum. Sewing toe, extensor tendon, toe, flexor tendon and toe, finger nerve. Anastomosis of the toe, finger veins and arteries, reconstruction and reconstruction refers to blood circulation. 7, re-creation, the middle finger of the end of the palm. 8, back side view. complication Nursing intervention to ensure that the patient is well coordinated with the patient has been in an emergency state, and the postoperative position is forced, which can easily lead to anxiety and sleep pattern disorder. At the same time, reengineering means that the risk of surgery is very high. If a failure or complications occur, the patient is often difficult to accept, so the nurse should do a good job in post-operative health education. Inform the patient that the postoperative ward is absolutely non-smoking, because the cigarette contains nicotine, which is easy to cause vasospasm and prevent active and passive smoking. Ensure that the local temperature of the lamp is constant, and the lamp distance cannot be changed arbitrarily. The body position can be changed greatly, such as turning over, sitting up, getting out of bed, etc., which will seriously affect the revascularization, induce vascular crisis, various adverse stimuli and emotions. Instability, it is easy to cause vascular crisis.
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