Letter to the mother of a baby with hand and foot deformity surgery

  1, and finger postoperative discharge with only Bactrim ointment is sufficient, so as to be used in the outpatient follow-up medication change.  2.The trauma on the lateral side of the finger after the juxtaposition is usually repaired by full-thickness skin grafting (i.e., commonly known as skin grafting), and the first dressing change is made 2 weeks after the operation without removing the stitches.  (1) If the skin piece is alive and well, the area is dry, saline wash or 1% iodophor disinfection and then apply Bactrim, then separate and straighten the finger bandage for 2 weeks; (2) If the skin piece has partial epidermal necrosis and oozing, it needs to be changed once in 3-5 days until the trauma is healed.  (3) Part of the concurrent fingers need to be fixed in the straight position with Kirschner pins. If there are Kirschner pins fixed during the operation, the pins are usually removed about 3-4 weeks after the operation. The needle can be removed during the outpatient medication change. After the needle is removed, the physician will usually see if the needle tip is intact to avoid broken needles. If the Kirschner needle is fixed across the joint, the joint can be moved appropriately after the needle is removed to avoid joint stiffness. Joint activity will be painful at the beginning, the child is generally reluctant to cooperate, can be from passive activity to active activity, from less to more process.  4. Pay attention to the protection of the dressing, never wet the dressing, especially within 1 week after the operation. Here I emphasize very much not to wet the dressing, because the most important thing after the skin implantation is the fixation and braking of the skin piece. This situation is like planting a flower, the newly planted flower cannot be shaken and the soil cannot be changed. (If the dressing is wet, it is better to use hair dryer to dry it immediately, but this situation is still damaging to the skin piece and affects the survival of the implant.  You can wear thin stockings to avoid soiling of the dressing. Try to reduce hand activities to avoid sweating more, which can easily cause wound infection. If you smell bad odor after surgery, you may have wound infection. You can consult your doctor (because some hands have sweaty odor after being bandaged for a long time, which is different from the odor of infection), and let the doctor help to determine whether it is the odor of infection, if it is, you need to change the medicine decisively. Pay attention to the affected hand after surgery and avoid violent impact, crawling on the bed and floor, but general daily activities are allowed.  5.Finger flexion, lateral deviation, and rotational deformity of the fingers often appear after juxtaposition surgery. Most of these deformities are caused by complex juxtaposition, accompanied by bone and joint, tendon or skin soft tissue abnormalities, some of which can be corrected at the same time when juxtaposition is separated, and some of which require second-stage correction.  6.Postoperatively, due to scar proliferation and pulling, finger web crawling (i.e. finger web becomes shallow), flexion and lateral deviation of finger body, etc. In this case, anti-scar treatment, or small splint fixation, or pressure finger web, or elastic glove, or brace fixation can be used to counteract the corrective treatment (it is better to review the above cases at the clinic so that the doctor can check the specific situation and adopt a reasonable method, and teach the correct treatment to the mothers).  7. The transplanted skin pieces may have different degrees of contracture in 1-3 months after surgery, resulting in flexion of the fingers, which also requires anti-scar treatment after surgery. The color of the transplanted skin piece is different from the normal skin, usually with dark color or even severe pigmentation, so regular follow-up is needed to do the corresponding treatment according to the situation, and avoid sun exposure in the skin graft area for six months.  8. 1-6 months after surgery, the scar is in the proliferation period, according to the situation, anti-scar treatment can be carried out, generally after 6 months, the scar starts to gradually soften and relax. Therefore, regular follow-up is required 1 month, 3 months and 6 months after surgery.  9.For the post-operative period of juxtaposition, I would like to emphasize two points again: never wet the dressing and the regular post-operative follow-up is very important.  10.I wish all babies grow up healthy and happy, and all have a bright future.