Nursing care of a patient after a craniofacial area microsurgical transplant in a teenage boy

Zuzanna Roman, Małgorzata Barbara Roman, Malwina Pułym-Ejsmont
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Abstract

Aim. The aim of the study was to make selected nursing diagnoses for a patient after a microsurgical transplant in the facial area, with the aim of providing the patient with comprehensive care in the perioperative period. Material and methods. The study describes the case of a child after microsurgical transplantation of a flap taken from the left iliac plate to the right submandibular region. The individual case method was used. Clinical interview, observation, measurement and medical documentation data were analyzed. Results. Four selected nursing diagnoses were presented along with planned interventions: risk of complications at the site of microsurgical flap transplantation, risk of donor site infection, discomfort caused by intense oozing of secretions from the postoperative wound in the oral cavity and the boy’s depressed mood caused by low self-esteem resulting from the changed postoperative facial appearance and the failure of the first surgical procedure. Conclusions. Nursing interventions should be adapted to the patient’s dynamically changing recovery process. They should be based on systematic inspection of the recipient and donor sites for the occurrence of complications. Education of the patient and the caregiver is an important element of the therapeutic process. It was not possible to significantly improve the child’s mood.
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十几岁男孩接受颅面部显微外科移植手术后的护理工作
研究目的本研究的目的是对面部显微外科移植术后的患者进行选定的护理诊断,以便在围手术期为患者提供全面护理。 材料和方法。本研究描述了一例将左侧髂骨板上的皮瓣移植到右侧颌下区域的显微外科手术后患儿的病例。研究采用了个案研究法。对临床访谈、观察、测量和医疗记录数据进行了分析。 结果。结果显示了四个选定的护理诊断以及计划的干预措施:显微外科皮瓣移植部位并发症的风险、供体部位感染的风险、术后口腔伤口分泌物大量渗出导致的不适以及术后面部外观改变和第一次手术失败导致的自卑造成的男孩情绪低落。 结论护理干预应适应患者动态变化的恢复过程。护理干预应以系统检查受体和供体部位是否出现并发症为基础。对患者和护理人员进行教育是治疗过程中的一项重要内容。无法明显改善患儿的情绪。
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