| Primary Author: | Thanaporn Kaewruang, Bsc |
| Co-Principal Investigators/Collaborators: | Suteera Pradupwong, RN, Kamonvav Jeanviteesuk, MD, Darawan Augsornwan, RN, MPH |
| Organization | Khonkaen University |
Abstract
Background
Patients after replantation/free flap coverage operation need close flap monitoring for 5 days. Previously monitoring tools made decisions difficult such as assessment of the temperature by touching the skin, so can not be sure if it cold or cool. Also there can be difference between the record of the observer, some may say warm or cool or cold temperature so hard to arrive at objective decision. This can cause delay of notification and delay of treatment.
Research Question
How to monitor the replantation effectively after surgery?
Objective
To develop replantation monitoring tools for patients who are undergoing replantation / free flap coverage surgery.
Materials & Methods
This study is an action research. The sample population were 9 patients and 10 nurses . We developed and modified a replant/flap monitoring chart combined with infrared thermometer for assessment of the replant/flap. Validity was checked by physician and expert nurse. Observation in each patient by 2 staff nurse .. Data analysis was by kappa statistical and ICC (Intra-class Correlation)
Results
83.33% of patients had hand injury from accident. 66.67% of patients with gum cancer.
The Intra-class correlation (ICC) of infrared thermometer monitoring is 0.984 (95% ICC = 0.979 – 0.987). The Kappa for capillary refill, color, turgor monitoring is 1.00 (P = 0.07),1.0(P = 0.05) และ 1.00 ( P =0.02)
Conclusion
The monitoring tools are good for patients with replantation/free flap coverage. However the sample size of this study was small, so need more further study.
Bibliography
Buncke H.J. Lineawaver, W.C. Valauri, F.A., Buncke, G.H. (1991). Monitoring. In Microsurgery: transplantation, Replantation: and Atlas- text. Philadelphia: Lea & Febiger, 715.
Weinzweig, J. (1999). Plastic surgery secrets. Bangkok: Book Promotion service.
Webster, M. H.C, Soutar, D.S. (1986). Practical guide to free tissue transfer. London: Butterworths.
Waikakul S. Microsurgery the limb. (2004). Bangkok. Holistic puplising.
© Improvement Science Research Network, 2012
The ISRN published this as received and with permission from the author(s).