Application of exposed therapy in wound nursing after the skin flap transplantation for lower extremity injury

Abstract

Objective To explore the effect of exposed therapy in wound nursing after the skin flap transplantation for lower extremity injury. Methods During January and August 2012, forty three patients, who underwent skin flap transplantation for the lower extremity injuries with soft tissue defect and whose wounds were bandaged using conventional gauze bandaging therapy, enrolled as control group. From September 2012 to April 2013, forty two patients with lower extremity injuries applied the exposed therapy when wound dressings were removed during 6 to 8 hours after surgery after skin flap transplantation as intervention group. This study aimed to evaluate the effect of conventional bandage therapy and exposed therapy by conducting the comparisons on blood circulation of transplantation flap, flap survival rate, wound infection and medical cost. Results The color, swelling and filling degree of transplanted flap in the intervention group were better than those in the control group (Z=5.63, 6.47, 6.48, respectively; P<0.01). The rate of flap normal temperature and flap survival rate were 83.33% and 97.62% in the intervention group, higher than those in the control group (χ2=7.40, 5.91, respectively; P<0.05). The wound infection rate was lower in the intervention group than that in the control group (Z=5.29; P<0.01). The data of intervention group were lower than those in the control group at medical cost, hospitalized days, switching medicine times and length of nursing (t=2.44, 32.78, 22.44, respectively; P<0.05). Conclusions For patients with skin flap transplantation, exposed therapy can effectively reduce the incidence of wound infection, and facilitate the direct observation of the flap blood circulation and the early detection of vascular crisis, so as to adopt the effective measures to prevent vascular crisis and improve the survival rate of skin flap. Key words: Skin flap transplantation; Wound nursing; Exposed therapy; Flap vascular crisis