Study on the nursing and evaluation of vascular crisis in the reconstruction of full thickness defects resulting from oral cancer with folded free flap

Abstract

Objective To explore a proper manner for the prevention and evaluation of vascular crisis, and to improve the success rate of flaps for full thickness defects in patients suffering from oral cancer. Methods Patients suffering from oral cancer (37 cases) during August 2013 and August 2015 underwent one stage radical surgery and reconstruction of full thickness defects with free folded flap. Flaps were observed and evaluated according to the criteria of vascular crisis prevention, including the color, density, temperature of both sides (intra/extra-oral) . Once such parameters were 20% lower than the standard, it was reported to surgeons at once and proper measures were taken. Results Six cases of vascular crisis were found in no more than three days post-operation, including four cases of venous thrombosis and two cases of arterial thrombosis. All these cases recovered after proper treatment. Conclusion It is important to observe and evaluate the flap according to the criteria of vascular crisis prevention, which is of help in improving the success rate of surgery. Key words: Oral cancer; Free folded flap; Vascular crisis; Nursing