Study on the prevention and nursing intervention of infection after flap transfer for hand trauma

Abstract

To analyze the factors associated with infection after flap transfer for hand trauma and use them to develop nursing strategies and observe the effects of their application. Eighty-two patients admitted to our hospital for flap transfer for hand trauma from January 2020 to May 2020 were selected for the retrospective analysis. Logistic regression analysis was performed to analyze the factors associated with postoperative infections to develop care strategies. Another 88 patients admitted for flap transfer for hand trauma from September 2020 to June 2021 were retrospectively analyzed and divided into the observation (n = 44) and control groups (n = 44) according nursing strategies that they received. The operative time, intraoperative bleeding, incision healing time, first postoperative time to get out of bed on their own and hospital stay were compared between the 2 groups. The patients postoperative adverse effects and flap survival rates were also counted. visual analogue score, total active motion, manual muscle test, Barthel index, self-rating anxiety scale, self-rating depression scale scores were used to assess patients pain, hand function recovery and psychology before and after treatment. Logistic regression analysis manifested that postoperative bed rest time, affected limb immobilization, and pain were independent factors affecting postoperative infection after flap transfer (P < .05). After using targeted care strategies, the observation group had dramatically shorter operative time, intraoperative bleeding, incision healing time, time to first postoperative bed release on their own, and hospital stay, less postoperative pain and adverse effects, and higher flap survival rate than the control group (P < .05). Total active motion, manual muscle test, and Barthel index were higher in the observation group than in the control group after treatment, while self-rating anxiety scale and self-rating depression scale scores were lower than in the control group (P < .05). Finally, total satisfaction was higher in the observation group than in the control group (P < .05). Postoperative bedtime, fixation of the affected limb, and pain are independent factors affecting postoperative infection after flap transfer for hand trauma. Implementing infection prevention care strategies based on these factors can effectively improve the safety of flap transfer, reduce the possibility of infection, and shorten the recovery period of patients, which has high clinical application value.

Figure 1.

Comparison of surgical situations. (A) Comparison of operative time. (B) Comparison of intraoperative bleeding. Note: * it means that there is a significant difference between the 2 groups (P < .01).

Figure 2.

Comparison of postoperative conditions. (A) Comparison of incision healing time. (B) Comparison of time to first postoperative voluntary bed release. (C) Comparison of hospital stay. Note: * it means that there is a significant difference between the 2 groups (P < .01).

Figure 3.

Comparison of pain conditions. Note: # represents a significant difference compared with T0 (P < .05), & represents a significant difference compared with T1 (P < .05), @ represents a significant difference compared with T2 (P < .05), * represents a significant difference compared with control group (P < .001).

Figure 4.

Comparison of functional recovery of hands. (A) Comparison of total active motion (TAM). (B) Comparison of manual muscle test (MMT). (C) Comparison of Barthel index (BI). Note: # represents a significant difference compared with before treatment (P < .05), * represents a significant difference compared with control group (P < .001).

Figure 5.

Comparison of psychology. (A) Comparison of self-rating anxiety scale (SAS) scores. (B) Comparison of self-rating depression scale (SDS) scores. Note: # represents a significant difference compared with before treatment (P < .05), * represents a significant difference compared with control group (P < .001).