Initial clinical experiences in post-operative care of microsurgical patients
Initial clinical experiences in post-operative care of microsurgical patients
Giang Nguyen Ngan BSN, Ha Nguyen Hông Ph.D, Thai Pham Hong BSN
Abstract
Aim: To summarise the initial clinical experiences in post-operative care of patients undergoing microsurgery.
Methods: The study design was a retrospective descriptive analysis. Subjects were patients that underwent reconstruction of amputated body parts and free tissue transfer by microsurgical technique from August 2007 to August 2010. The data, which were based on the research targets, were collected from medical and nursing records. Variables evaluated included patient age, sex, occupation, cause, position, preservation, property of surgery, complications, nursing record (vital signs, wound appearance, other clinical presentations) and outcomes.
Results: Sixty-eight patients were enrolled in the study. Eighty-five percent of cases were limb and digit replantation, 9% were scalp and facial tissue replantation, and the remaining 6% were penis, breast and other body parts. The majority (87% of cases) were emergency surgeries and the remainder (13%) of cases were preparative surgeries. Post-operative complications included infection (21%), venous thrombosis (13%), arterial thrombosis (7%), and haemorrhage (4%). Necrosis occurred in 9% of patients. The overall survival rate was 78% with a partial survival rate of 13%.
Conclusion: This was an initial retrospective descriptive study. The complication rate was the main issue that had a negative effect on the quality of outcomes. Microsurgery techniques were varied. The post-operative monitoring and nursing care had not been consistent with the specialty. Therefore, the proportion of successful outcomes was not high. In the future, it is anticipated the systematic review and implementation of evidence-based, consistent surgical techniques and nursing care will decrease post-operative complications and improve the quality of outcomes for patients
Giang Nguyen Ngan BSN, Ha Nguyen Hông Ph.D, Thai Pham Hong BSN
Abstract
Aim: To summarise the initial clinical experiences in post-operative care of patients undergoing microsurgery.
Methods: The study design was a retrospective descriptive analysis. Subjects were patients that underwent reconstruction of amputated body parts and free tissue transfer by microsurgical technique from August 2007 to August 2010. The data, which were based on the research targets, were collected from medical and nursing records. Variables evaluated included patient age, sex, occupation, cause, position, preservation, property of surgery, complications, nursing record (vital signs, wound appearance, other clinical presentations) and outcomes.
Results: Sixty-eight patients were enrolled in the study. Eighty-five percent of cases were limb and digit replantation, 9% were scalp and facial tissue replantation, and the remaining 6% were penis, breast and other body parts. The majority (87% of cases) were emergency surgeries and the remainder (13%) of cases were preparative surgeries. Post-operative complications included infection (21%), venous thrombosis (13%), arterial thrombosis (7%), and haemorrhage (4%). Necrosis occurred in 9% of patients. The overall survival rate was 78% with a partial survival rate of 13%.
Conclusion: This was an initial retrospective descriptive study. The complication rate was the main issue that had a negative effect on the quality of outcomes. Microsurgery techniques were varied. The post-operative monitoring and nursing care had not been consistent with the specialty. Therefore, the proportion of successful outcomes was not high. In the future, it is anticipated the systematic review and implementation of evidence-based, consistent surgical techniques and nursing care will decrease post-operative complications and improve the quality of outcomes for patients