A multidisciplinary approach to amputation in a case of severe developmental disorder of extremities caused by acroscleroderma / 中国实用护理杂志

ABSTRACT

Objective:To explore the perioperative safety management of patients with severe limb dysplasia, to select appropriate methods to monitor vital signs, and to prevent intraoperative acquired pressure sore, nosocomial infection and other related complications.Methods:A case of severe developmental disorder of extremities caused by acroscleroderma in November 2019 in Peking University Shenzhen Hospital needed to be amputated. By organizing multidisciplinary consultation to discuss the operation plan, repeatedly selecting appropriate tools, and multiple scenario simulation exercises, continuous transcutaneous oxygen saturation and noninvasive blood pressure monitoring could be realized for the patients with acromegaly deficiency of the extremities. Under the monitoring of color ultrasound, the arterial blocking pressure of the extremities was determined as the tourniquet pressure during the operation value, take appropriate measures to prevent intraoperative acquired pressure sore, nosocomial infection and other related complications.Results:With the cooperation of multidisciplinary team, amputation was successfully carried out for the patients. The position was comfortable during the operation, the operation process was smooth, the residual limbs healed well after the operation, and there was no intraoperative acquired pressure sore, nosocomial infection and other related complications.Conclusions:To establish a multidisciplinary cooperation mechanism, strengthen the construction of the operating room special group, and use evidence-based nursing methods and actual scenario simulation exercise can ensure the perioperative safety of patients with severe developmental disorder of extremities and similar patients with special body shape or very low weight.