ABSTRACT
Objective:To explore the clinical effect of the second toenail flap with the dorsal bone of the phalange in repairing the defect of fingernail bed.Methods:From January, 2012 to June, 2019, 10 patients with large area of fingernail bed defect were treated by the second toenail flap with bone on the back of the phalanx. The survival of the flap was observed after the operation, and the fracture healing, the shape of the nail and the flexion and extension function of the finger joint were observed in the outpatient follow-up.Results:All flaps of the second toenail survived. The average follow-up period was 8 (4-12) months. The fractured ends of 10 patients' phalanges healed well without nonunion, good appearance of toenail and deformity of toenail. The recovery of hand function was evaluated according to the evaluation standard of upper limb function of Hand Surgery Society of Chinese Medical Association, 9 cases were excellent, and 1 case was good.Conclusion:The second toenail flap with dorsal bone of the phalanx preserved is easy to cut, simple to operate, and has good clinical effect. It is a good method to repair the defect of the fingernail bed.
ABSTRACT
Objective:To explore the clinical effect and nursing experience of papaverine intramuscular injection after finger replantation with self-designed hip intramuscular injection positioning device.Methods:Totally 216 cases of patients treated with palavering for anti-vasospasm after of severed fingers from January 2018 to December 2019 were randomly divided into control group (108 cases) and observation group (108 cases) by random number table method. The control group received intramuscular injection of buttock muscle according to the conventional method, and the observation group used the auxiliary intramuscular injection with self-designed glutei muscle positioning device. The incidence of postoperative hip indurations and ecchymosed, survival rate of and buttock were analyzed Pain scores were compared.Results:Totally 76 cases (70.37%) and 62 cases (48.15%) in the control group, 12 cases (11.11%) and 6 cases (5.56%) in the observation group. The difference between the two groups was statistically significant ( χ2 values were 78.545, 67.307, P<0.01). 78 cases (72.22%) survived in the control group and 96 cases (88.89%) survived in the observation group ( χ2 value was 11.416, P<0.01). After papaverine intramuscular injection, there was no significant difference in hip pain score between the two groups on the first and second day ( P>0.05), but there was significant difference between the two groups on the third to seventh day ( t values were 17.17 to 45.97, P<0.05). Conclusion:Palavering intramuscular injection can reduce the incidence of hip indurations and ecchymosed, relieve buttock pain and improve the survival rate of amputated finger, which is worthy of clinical application.
ABSTRACT
Objective:To explore the effect of self-designed fixed support in the postoperative nursing of abdominal flap repair.Methods:From January 2016 to December 2019, 47 patients with hand tissue defects undergoing abdominal skin flap repair in Shajing People′s Hospital, Guangzhou Medical University were divided into control group (23 cases) and observation group (24 cases) by random digits table method. The control group was treated with traditional methods, and the observation group was treated with self-designed fixed support. The wound healing of abdominal flap, the wound tearing after flap operation, pedicle ulcer after flap operation and the patients' nursing satisfaction were compared between the two groups.Results:There were 7 cases of primary healing and 16 cases of secondary healing in the control group, 18 cases of primary healing and 6 cases of secondary healing in the observation group. The difference between the two groups was statistically significant ( χ2 value was 9.368, P<0.01). The incidence rate of the wound tearing after flap operation was 26.1% (6/23) in the control group and 0 (0/24) in the observation group. The difference between the two groups was statistically significant ( χ2 value was 7.177, P<0.05). The incidence rate of pedicle ulcer after flap operation was 69.6% (16/23) in the control group and 33.3% (6/23) in the observation group. The difference between the two groups was statistically significant ( χ2 value was 6.170, P<0.05). The patients' nursing satisfaction was (76.8±8.4)points in the control group and (90.4±6.5) points in the observation group.The difference between the two groups was statistically significant (t value was -4.640, P<0.01). Conclusions:The use of fixed support after the operation of abdominal flap is helpful to the wound healing, reduce the occurrence of wound tear and pedicle ulcer, and improve the satisfaction of nursing, which is worth popularizing.