Effect of Health Care and Rehabilitation Nursing and Analysis of Neurovascular Preservation of Patients Undergoing Reconstruction of Severed Finger under X-ray Image Examination.

OBJECTIVE: The study aimed to provide a guideline for continuous rehabilitation nursing for patients with severe finger replantation, and establish a satellite contact point for patients with severe finger replantation after discharge, so as to ensure scientific and effective rehabilitation training after discharge and explore the role of continuous rehabilitation nursing measurement in severe finger rehabilitation and neurovascular preservation. METHODS: A total of 380 patients accepting neurovascular preservation finger replantation in the hand surgery department were divided into an observation group and a control group according to the number of hospitalizations. All patients underwent reconstructive surgery of severed finger. X-ray filming was used to monitor the postoperative nursing effect of neurovascular preservation of severed finger. The discharged patient information questionnaire was filled 3 days before the discharge. Then, a patient information database was established, and rehabilitation training was performed. Finally, sexual rehabilitation nursing follow-up intervention, telephone follow-up, and cross-referring intervention were carried out. Postoperative x-ray images were taken regularly to observe the recovery of reconstructed finger. RESULTS: There was no difference in daily life ability scores and hand function scores between the 2 groups at discharge (P > 0.05). The daily life ability scores and hand function scores of the observation group were better than those of the control group at 1 and 6 months after discharge (P < 0.05), the difference is statistically significant. As the discharge time prolonged, the daily life ability score and hand function score of the 2 groups of patients gradually increased. X-ray images showed that the replanted finger body was well developed, phalanx was in good antithesis, and there was no epiphysis. CONCLUSIONS: Continuous rehabilitation nursing measures should be taken after the replantation of the severed finger after neurovascular preservation, which provides standardized rehabilitation training standards for patients with replantation of severed finger after discharge, improves patient training compliance, promotes hand function recovery as soon as possible, and enables patients to return to society as soon as possible, which is worthy of clinical promotion and application.

Fingertip injuries in children: a review of the literature.

Fingertip injuries in children are a common presentation in emergency settings. These injuries result from a variety of mechanisms with most occurring at home by crushing fingers in a door and are distressing for the child and parent or carer. It is essential that emergency clinicians respond competently and confidently. This article reviews the literature on the management of fingertip crush injuries to establish, where possible, best evidence. The article also describes the anatomy and assessment of the finger in relation to fractures of the distal phalanx, nail bed injury and subungual haematoma, and considers the use of antibiotics in the treatment of a subungual haematoma with a distal phalanx fracture.

[Negative pressure therapy in traumatology]. / La thérapie par pression négative en traumatologie.

The treatment of complex wounds in traumatology is a source of concern for nurses. Negative pressure therapy constitutes a solution for difficult-to-treat situations in the framework of open fractures and loss of limb tissue.

Patient rehabilitation following lower limb amputation.

Patient rehabilitation following lower limb amputation is essential to provide optimum patient outcomes and to improve the amputee's quality of life. The age of the patient and the stump length or level of amputation emerge as dominant factors affecting the outcome of rehabilitation. A variety of outcome measures are available to assess the patient's rehabilitative potential to maximise functional ability. This article focuses on the factors affecting rehabilitation, outcome measures to assess rehabilitative potential and the nurse's role in providing care for patients following lower limb amputation.

Actuación de enfermería en paciente con mano catastrófica por explosión de petardos / Nursing care plan of a patient with traumatic hand injuries caused by firecracker explosion

Se presenta el caso clínico de un adolescente que presenta amputación traumática de la mano derecha y otras heridas más leves provocadas por la explosión de petardos y cohetes tras su incorrecta manipulación. Al llegar a la Unidad de Urgencias del Hospital de Traumatología y Rehabilitación Virgen del Rocío (Sevilla) se trataron de manera inmediata sus lesiones. La prevención del shock y el tratamiento del dolor fueron aspectos prioritarios en su asistencia. Tras una exhaustiva valoración del paciente, se seleccionaron 6 diagnósticos de enfermería, y se planificaron las intervenciones más apropiadas para cada uno de ellos, utilizando la taxonomía NANDA, NIC y NOC. Con esta actuación se contribuyó, en gran medida, a mejorar el estado de salud del paciente, tanto física como psicológicamente. Para disminuir el número de lesionados por manipulación inapropiada de material pirotécnico, sería conveniente realizar en colegios e institutos, y en coordinación con atención primaria, programas de prevención de accidentes pirotécnicos

We report the case of a teenager with traumatic amputation of the right hand and other less severe wounds caused by explosion of firecrackers and rockets after faulty handling by the boy. On arrival at the Emergency Unit of the Virgen del Rocío Orthopedic and Traumatology Hospital (Sevilla, Spain), the boy's injuries were immediately treated. Priorities were to prevent shock and alleviate pain. After an exhaustive assessment of the patient, six nursing diagnoses were selected. The most appropriate interventions for each of these diagnoses were planned, using NANDA, NIC and NOC taxonomy. This approach greatly contributed to improving the patient's physical and psychological status. To decrease the number of injuries caused by faulty handling of fireworks, programs for accident prevention should be carried out in schools in conjunction with primary care

Case management: heart and soul.

Dear Colleagues: As a seasoned case manager, I have had the opportunity to serve our specialty practice in the development of the definition of case management, the creation of our standards of practice, the evolution of our professional code of conduct, and, of course, the process of certification. Yet it is the stories of our shared time with our clients that truly define what we do and who we are and clarify our contribution to health care. It is by the telling of the story that we understand our roles, our behavior, and the value of our activities.

Duelo y pérdida corporal / Bereavement and body loss

Se suele asociar el concepto de duelo a la labor mental que realiza una persona ante la pérdida de un ser querido. En este trabajo se describe la vivencia de dolor psíquico ante un pérdida de una parte del cuerpo ocurrida súbita y accidentalmente. Para ello se destaca la formación del esquema corporal, base de la identidad personal y del núcleo del Yo. Se estudia la interrelación cuerpo-mente para comprender mejor los efectos de esa pérdida y las fases y características por las que transcurre el proceso del duelo como labor psíquica. Se consideran las cualidades traumáticas de los accidentes que causan amputaciones y pérdidas corporales significativas y las reacciones de los pacientes, deteniéndonos en la importancia de la tarea que se impone al psiquismo consistente en intentar dominar, canalizar, metabolizar y dar salida encauzada a esas ansiedades de muerte que han irrumpido violentamente. Estudiamos en detalle los fenómenos oníricos y la presencia del fenómeno del miembro fantasma. El dolor del miembro fantasma es el dolor de la memoria o la memoria del dolor. Se ilustran los conceptos descritos mediante las viñetas clínicas de dos pacientes que habían sufrido pérdidas corporales en sendos accidentes. Se concluye que la ayuda terapéutica que debemos prestar a estos pacientes tiene por objetivo una reorganización emocional que atenúe su dolor psíquico, transformándolo en saber y aceptación tolerante de la pérdida, convirtiendo ese saber y tolerar en contenido de vida para el porvenir. (AU)

Individualized doll therapy with children experiencing limb loss.

Caring for the child and family experiencing a limb loss can be one of the most challenging opportunities for the health care worker. A family-centered approach provides a caring and compassionate way for the child and family to view the complicated medical world. One method that bridges communication between the health care team, patient, family, and community is doll therapy. Individualized doll therapy can help the child understand the amputation, physical limits, prosthetic care, and body image.

Scalp replantation after traumatic injury.

A 30-year-old female patient lost her scalp in an industrial accident. Surgeons used a microscope to reconnect the arteries and veins in her scalp and to reattach the scalp to the patient's cranium. The patient tolerated the procedure without complications, although she developed venous congestion in her right ear while she was in the neuroscience intensive care unit. After several days of leech therapy, the patient experienced an uneventful postoperative course. One month after discharge from the hospital, the patient's hair was growing back in and her incision lines were fading.