The Research On The Influence Of Systematic Attendance Intervention To Postoperative Venous Crisis Of The Free Flap Transplantation

Objective:To discuss the influence of systematic attendance intervention topostoperative venous crisis of the free flap transplantation, regulatepostoperative attendance of the free flap transplantation, reduce the incidence ofvenous crisis,and guarantee the success of the operation.Methods:105postoperative cases of the free flap transplantation (including65casesof radial forearm flaps,21cases of fibular myocutaneous flaps and19cases offemoral anterolateral flaps) were choosed and randomly divided into2groups,intervention group (54cases) and control group(51cases),by odd and evennumbers of the surgery date in the Hand-foot surgery department of the firsthospital of Jilin university from April2013to October2014.The control groupaccepted attendance routine normally, including keeping up surgical area10-20cm by the cotton pillow; illuminating surgical area by the electric heatlamp; putting patients at ease by psychological intervention; observing the flapclosely to discover venous crisis as earlier as possible. The intervention groupaccepted systematic attendance intervention, including fixing surgical area byhomemade specific bracket; keeping surgical area a certain temperature and humidity by homemade constant temperature and humidity chamber; assessingpatients’ mentation by SAS and SDS self-rating scales, nursing patients byhomemade prescription of psychological intervention; massaging the flap bycotton swab. The patients in the2groups were observed at the same time andrecord the occurrence of venous crisis at the same point.The data were analyzedby SPSS17.0.Results:The two groups had no significant difference in age, gender, flap area(P>0.05). The two groups had no significant difference in surgery reasons, thetypes of flap (P>0.05).(1) Compared intervention group with control group in postoperativementation of the free flap transplantation,including anxiety and depression:thescores had no significant difference preoperatively、on the day of operation、onthe1th day and3th day postoperatively(P>0.05), the scores had significantdifference on the5th day and7th day postoperatively(P<0.05).(2) Compared intervention group with control group in postoperatively theoccurred time of venous crisis of the free flap transplantation: the occurred timeof venous crisis had significant difference (P<0.05).(3) Compared intervention group with control group in the ocurrence ofvenous crisis of the free flap transplantation in postoperatively different periods:the occurrence of venous crisis in the1th and2th period had significantdifference (P<0.05). the occurrence of venous crisis in the3th and4th period had no significant difference(P>0.05).(4) Compared intervention group with control group in the ocurrence ofvenous crisis of the free flap transplantation: the occurrence of venous crisis hadsignificant difference (P<0.05).Conclusions:(1) The homemade prescription of psychological intervention can relieveanxiety and depression of postoperative patients of the free flap transplantation.(2) Systematic attendance intervention can delay the occurred time ofvenous crisis effectively.(3) Systematic attendance intervention can significantly control theincidence of venous crisis of the free flap transplantation in the1th and2thperiod, otherwise, have no effect on the incidence of venous crisis in the3th and4th period.(4) Systematic attendance intervention can significantly reduce theincidence of venous crisis of the free flap transplantation.