Lower limbs; Skin traction; nurse
Lower limb traction sleeve is widely used in orthopedics, which is a simple and effective treatment method. Mainly suitable for lower limb fracture (stable closed fracture), joint ligament injury, inflammatory fixation of bone and joint, pathological fracture, etc. Aiming at the problems found in clinical practice, this paper discusses the improvement of skin traction nursing method for lower limbs.
1 data and methods
1. 1 general information
From 2005 to 2007, 200 inpatients received skin traction of lower limbs.
1.2 method
The specifications of lower limb traction sleeve used in our hospital are divided into three types: large, medium and small, and the types are divided into lower limb long leg traction sleeve and ankle traction sleeve. During traction, different specifications are selected according to the fracture site and the length and thickness of the patient's limbs.
2 problems found in nursing care
(1) When the traction sleeve slides down, the stress is concentrated on the heel and instep, and the binding of the edge of the traction sleeve causes pressure sores and blisters on the skin, which damages the skin and fails to achieve traction effect. After the traction sleeve slides down, it causes repeated adjustment of traction, moves the patient's limbs, brings pain to the patient, and directly affects the traction effect. (2) The traction sleeve directly wraps the limbs and binds them in sections, which makes the skin squeeze and wrinkle, affects the circulation and easily damages the skin. Adding padded cotton in the traction sleeve is easy to cause sweating, fever, humidity and odor after traction. (3) Long-term compression of fibular capitulum is easy to cause common peroneal nerve injury. (4) Improper traction leads to the skin damage of the patient's heel, which is difficult to heal due to local lack of muscle tissue wrapping.
3 nursing skills
3. 1 The size of the traction sleeve should be selected properly.
If the patient's physique is thin and the traction sleeve does not match the circumference of the limb, the traction sleeve can be sewn down first to make its circumference match.
3.2 Choose cotton towel as filler.
Towels are longer than traction sleeves, and have the advantages of sweat absorption, good air permeability and easy cleaning. The upper and lower ends of the towel are folded back to prevent the skin from being damaged by the edge of the traction sleeve.
3.3 Operation method
3.3. 1 Traction skills of ankle traction sleeve
Choose a cotton towel to wrap the ankle of the affected limb. The width of the towel should be such that both ends of the ankle traction sleeve can be exposed after wrapping, and the edge of the wrapped towel should be exposed to the upper part of the affected foot. Relax the ankle traction sleeve 1 ~ 2 times a day, brake the affected limb after relaxation, and gently wipe the ankle with warm water. If the skin has wrinkles, massage with your fingertips in time, and continue to use the above method after smoothing the wrinkles.
3.3.2 Traction skills of traction sleeves for lower limbs and long legs
Wrap it in two big cotton towels. The wrapping method is similar to ankle traction, except that a towel wraps the lower limb thigh and a towel wraps the lower limb thigh. When wrapping, the starting point of the towel starts from the upper part of the leg, and the edge is turned up first to prevent the skin from being pressed by the corners of the traction sleeve. At the fibula capitulum, after the towel is wrapped up and down, when sticking the traction sleeve, the tightness of the traction sleeve should be based on the comfort of the patient and the strong pulsation of the dorsal artery of the foot. When pasting the traction sleeve, it should be pasted from the far end to the near end to prevent pasting from the near end to the far end. If it is too tight, the blood return at the distal end will be limited, and the swelling will bring discomfort to the patient. After sticking, the towel exposed from the traction sleeve will be folded back, which will not cause accumulation, and it is also beneficial to observe whether the surrounding skin, especially the heel skin, is abnormal.
3.3.3 After the traction sleeve is glued, put down the heavy metal hammer.
It should be reminded that the heavy hammer should not touch the ground, close to the bed rail, and should not increase or decrease the weight at will. The purpose of traction can be achieved through the traction of the human body and the reverse traction of the weight.
3.3.4 For patients with external rotation of limbs.
In order to keep the traction line, you can wear neutral shoes.
4 nursing effect and experience
(1) 200 patients with skin traction were treated by the above method, which reduced the risk of heel skin injury and prevented the skin injury caused by traction equipment. (2) For patients who cannot be dragged in the hospital for various reasons, nurses should teach their families how to operate, and dragging at home can also produce the same effect. (3) When carrying out skin traction on the affected limb of diabetic patients, it should be included in bedside shift, and the traction sleeve should be opened 2 ~ 4 times a day to help massage the compressed part every day to improve skin resistance. (4) After adopting the above operation method, the number of times for nurses to adjust traction is reduced, and the pain caused by moving patients' limbs is avoided. Through the clinical application of lower limb skin traction, combined with the reality, improving nursing skills plays an active and effective role in improving patients' comfort, relieving patients' pain, improving traction success rate and reducing complications.