Routine care for foot injuries
Most foot injuries are complex injuries, often accompanied by skin, bone, joint, tendon, nerve, and vascular injuries.
Clinical manifestations include local pain, bleeding, deformities, and movement disorders accompanied by sensory numbness, pigmentation, swelling, fractures, etc. Severe cases can cause systemic symptoms. 【 Treatment principles 】 1. On site first aid: assess the injury, local hemostasis, bandaging, and fixation. 2. Thoroughly clean the wound in the early stage and handle deep tissue damage correctly. 3. Close the wound in the first stage and fix the fracture. 4. Proper preoperative and postoperative care. Nursing assessment: 1. Evaluate the blood supply of the injured limb and determine the timing of tightening or loosening the tourniquet. 2. Understand the location and nature of the wound, pay attention to whether the affected limb has fractures, dislocations, nerve, vascular, tendon injuries, etc. 3. Assess the overall condition, whether there is pain, shock caused by blood loss, and observe the degree of wound pain, blood loss, contamination, etc. 4. Understand the history of injury, medical history, psychological condition, and grasp the medication situation. Nursing measures: Follow the general nursing routine for surgical and orthopedic diseases. Preoperative care: 1. When there is significant bleeding in an emergency foot injury, immediately notify the physician to perform simple bandaging to stop the bleeding. 2. Rest in bed, raise the affected limb, protect the affected limb, and keep warm to prevent secondary injury.
3. Provide a high protein, vitamin rich, and nutritious diet. 4. If emergency surgery is required, actively prepare before surgery After the patient is injured, they should immediately start fasting and drinking, and strive for the best time for surgery (thorough debridement should be carried out as soon as possible to reduce infection); ② Assist in completing various preoperative examinations; ③ Provide psychological counseling, stabilize the patient's emotions, and actively cooperate with treatment. Postoperative care: 1. Understand the anesthesia situation during the operation, take a supine position after the operation, raise the affected limb, keep warm to facilitate venous return, and reduce swelling. 2. Provide a high protein, vitamin rich, and nutritious diet to promote the repair of nerves, blood vessels, and skin. 3. Closely observe the pain, exudate, bleeding, and other conditions of the wound, and keep the wound dressing clean and dry. 4. Patients undergoing vascular anastomosis should follow the nursing routine for finger replantation surgery (local insulation, use of antispasmodic and anticoagulant drugs, etc.). 5. Neuroanastomoses should pay attention to observing the recovery of nerve function and understand whether there is numbness or sensory recovery in the toe tips. 6. Patients with internal fixation of fractures need to rest in bed to avoid early weight-bearing of the affected limb, and emphasize the knowledge of preventing bed rest complications caused by deep vein thrombosis in the lower limbs. 7. Guide patients to engage in rehabilitation exercises (depending on the surgical condition, whether early functional exercises are necessary). (1) Patients with internal fixation of fractures can receive guidance on functional exercises such as toe movement after surgery. (2) Three days after tendon anastomosis, guide the patient to gradually start mild extensor and flexor muscle exercises depending on the condition
Tendon activity to prevent tendon adhesion. 【 Observation and Nursing of Complications 】 (1) Observation of Infection Condition: Local redness, swelling, heat, pain, and continuous increase in body temperature, with severe cases leading to
Symptoms of systemic poisoning, as well as increased white blood cell count and neutrophil count, and significantly accelerated erythrocyte sedimentation rate. Nursing: 1. For open foot injuries, on-site first aid and protection should be strengthened to avoid bacterial contamination and prevention
Stop the increase of pollution. Properly fix the area to prevent further damage and seek medical attention as soon as possible. 2. Timely and thorough debridement is the most important measure to control infection. 3. Observe the wound for redness, swelling, and exudate, and promptly replace the dressing to keep the incision dry,
Strictly follow aseptic procedures during dressing changes to prevent cross infection. 4. Reasonable use of antibiotics. 5. Strengthen nutrition and enhance the body's resistance. (2) Observation of nerve damage condition: Observe whether there are symptoms of nerve damage such as numbness and movement disorders in the affected limb,
And the recovery of nerves after nerve anastomosis. Nursing: 1. After feeling lost, pay attention to protecting the affected limb from burns, abrasions, and frostbite. 2. If burning neuralgia occurs, in addition to appropriate protection, the sealing method should also be used
treatment. 3. Prevent deformities and guide passive and active activities. 4. Apply some drugs and therapies that assist in vasodilation and promote nerve recovery. 5. Provide good health education to increase patients' confidence.
【 Health Guidance 】 1. Inform patients to pay attention to safety and avoid further injury (collision, cold burn). 2. Inform patients of the requirements for follow-up visits: ① For those with nerve damage, electromyography should be performed at 3 weeks, and then rechecked every 3 months to observe the recovery of nerve function; ② Patients with tendon injuries will have a follow-up examination 2 weeks after discharge, followed by follow-up examinations at 1 month, 3 months, and 6 months thereafter Patients with internal fixation of fractures should avoid early weight-bearing of the affected limb after discharge. Outpatient follow-up should be conducted monthly within 3 months, and every 3 to 6 months thereafter.
