The Effect Analysis Of Integrated Management Of Medical Care To Reduce The Incidence Of Complications Of Skin And Soft Tissue Expansionhe

Objective:To study the effect of the level of integrated management of medical care on the complication rates of skin and soft tissue expansion.Methods:The design adopts the before-after study,and objects of the study were those inpatients who got an operation of skin and soft tissue expansion at Burn and Wound Repair Surgery Ward and Plastic and Aesthetics Surgery Ward for a first-class ternary hospitals in Jinan.The study time is from January 2015 to January 2016. The control group is from January 2015 to June 2015 of 331 inpatients with skin and soft tissue expansion,and the experimental group is from July 2015 to January 2016 with 264 inpatients who have gotten the same operation.The baseline is the same:medical personnel stability study time, without change of health policy, with meaningless age and gender between the two group. The group of integrated management of medical care was established in July 2015, skin soft tissue dilatation complications care under special management team cooperation, and the team members have a clear rule to join and exit, setting up standard process, integrated management in analysis of 5 kinds of skin soft tissue dilatation common postoperative complications (hematoma,infection of incision, dilator exposed dilator expansion and skin flap necrosis) of the causes and affecting factors, proposed improved method, and then collaborative corrective, continuous quality improvement. To analyze the complications of intervention group and control group, the comparison and analysis to implement health care integration management of skin and soft tissue expansion complication rates before and after the study.Results:1.From January to June2015, hospitalized in undergraduate course room line of skin and soft tissue expansion of 331 cases of patients with postoperative complications is as below:(1) the total incidence of skin and soft tissue expansion complications was 10.27%, among them,128 cases of male incidence is 11.72%; 203 cases of female incidence was 9.36%.(2) each part of the skin and soft tissue expansion the incidence of complications, with the highest incidence of breast, at 50.00%, followed by limbs, rate of 20.00%; The incidence of the scalp is the lowest,for 2.78%.(3) in statistical skin and soft tissue expansion of 5 kinds of complications, the incidence rate of hematoma as the highest,61.76%; followed by infection of incision, incidence rate of 14.71%, of which the dilator not expansion and the incidence rate of skin flap necrosis was 6.06%, as a minimum.(4) complications for the treatment of skin and soft tissue expansion effect each are not identical, the complications of treatment success, has no influence on treatment effect accounted for 61.76%; Complications leading to expansion operation completely failure is 8.82%.(5) Have taken different time limit complications, statistics show that 1 expander placement total incidence of complications was 2.42%, the injection fluid during the incidence of complications was 4.83%, line 2) dilator remove skin flap, the incidence of complications was 3.02%.2.From July 2015 to January 2016, the department line of skin soft tissue expansion technique in 264 cases of hospitalized patients with postoperative complications as follows:(1) the total incidence of skin and soft tissue expansion complications was 5.68%, among them,124 cases of male incidence is 5.65%; 140 cases of female incidence was 5.71%.(2) each part of the skin and soft tissue expansion the incidence rate of complications is not the same, with the highest incidence of limbs, at 25.00%, followed by the ear, the rate of 7.89%; Frontal and breast without complications.(3) in statistical skin and soft tissue expansion of 5 kinds of complications, the incidence rate of hematoma as the highest,53.33%; Followed by infection of incision, incidence of 20.00%; Expander expanding and skin flap necrosis was not the lowest, 6.67%.(4) in the five kinds of common complications, each complication of treatment effect, complications, treatment timely and effective, does not affect the treatment effect is 66.67%; Complications cause dilatation completely failure is 6.66%.(5) the skin soft tissue expansion technique of 5 kinds of complications,1 dilator into the incidence of complications was 1.52%, when the incidence of complications was 2.27% during injection liquid, line 2) dilator remove skin flap, the incidence of complications was 1.89%.3. Hospital patient satisfaction:in from January 2015 to June 2015, the hospital medical job satisfaction was 93.05%; from July 2015 to January 2016, the degree of satisfaction was 99.62%.Conclusion:The integrated management of medical care can significantly reduce the incidence of skin and soft tissue expansion complication and improve the hospital patient satisfaction.