We hope that by reading this article, we can eliminate the fears of patients and their families about surgery and clarify the preoperative preparation process so that they can be well informed.
I. Pre-operative preparation
1. Heart care
Stabilize the patient’s mood, explain to the patient the knowledge related to surgery, and reduce the patient’s fear and anxiety about surgery.
2.Perfect the routine auxiliary examination
Such as blood routine, fasting blood sugar, liver and kidney function, clotting time, syphilis virus, HIV, hepatitis virus complete set, ECG, X-ray and other tests.
Train bed urination and defecation and instruct patients on the correct way to use urinal and potty.
3. The day before surgery
(1) Prepare the skin of the surgical field, ranging from the upper rib margin to the lower knee of the affected limb, anterior and posterior over the midline of the torso, shave the pubic hair, plot the umbilicus, trim the toenails, etc.
(2) Do penicillin and procaine drug sensitivity test, and prepare blood if necessary according to medical prescription.
4. Fasting for 12 hours and 6 hours of water before surgery.
5. On the day of surgery
(1) Disinfect the affected limb with 75% alcohol in the morning of surgery and then wrap it with sterile gauze.
(2) Ask the patient to empty the bladder and change into clean sick clothes and pants.
(3) Give preoperative medication 30 minutes before surgery as prescribed by the doctor.
(4) Remove the patient’s jewelry, watch, dentures, glasses and other valuables before surgery and give them to the family for safekeeping.
(5) Bring all kinds of films, intraoperative medications, etc., and hand over to the operating room staff.
II. Postoperative care
1. Care by epidural anesthesia
Remove the pillow and lie flat for 6 hours, head to the side, qh*3 times to measure blood pressure until stable.
2. Diet
Give the corresponding diet after 6 hours postoperatively as prescribed by the doctor.
3.Body position
(1) Lie flat for 6 hours after the operation, with appropriate too hip movement.
(2) Keep the affected limb in a neutral position, not externally or internally rotated, to prevent hip dislocation.
4. Observe the condition of the incision and the color, quality and quantity of the drainage fluid, and keep the drainage tube unobstructed.
(1) Observe the blood seepage from the incision, if there is more blood seepage, report to the doctor and help to deal with it in time.
(2) Observe the blood flow, temperature, color, degree of swelling, sensation and movement of the distal extremity of the affected limb, and report any obstruction of blood circulation to the physician for treatment.
(3) Properly fix the drainage tube and keep the catheter drainage open.
(4) Observe the color, quality and quantity of drainage fluid and keep records.
(5) The drainage tube is usually removed 48~72 hours after surgery.
5. Assessment of pain level
Pain of II degree or less should be given heart care and relaxation therapy. In case of pain of III degree and above, report to the doctor and assist in treatment.
6. Prevent pulmonary complications
Encourage the patient to do chest expansion, deep breathing, coughing, etc.
7.Prevent bedsores
Keep the bed unit neat and tidy, assist q2h too hip, and keep records to prevent decubitus ulcers.
8.Functional exercise
(1) Exercise the quadriceps muscle on the first day after surgery: tense the thigh muscle and straighten the knee joint as much as possible, holding it for 5 seconds each time.
(2) Instruct the ankle joint exercise of the affected limb.
(3) After the traction is removed, the upper body can be elevated 20~30 degrees, and one soft pillow can be placed under the N fossa to keep the knee joint slightly flexed, while the ankle joint can be moved to prevent stiffness of the distal joint.
(4) You can get out of bed 2~4 weeks after the operation according to the doctor’s advice, but do not bear weight.
9.Discharge instruction
(1) Follow the doctor’s instructions for outpatient review.
(2) Keep the area around the incision dry. If there is any redness or swelling, go to the hospital for follow-up in time.
(3) Avoid premature weight-bearing, follow the doctor’s instructions to move on the ground, pay attention to your own protection and prevent falls.
(4) Take medication on time according to medical advice.