Effect of Health Care and Rehabilitation Nursing and Analysis of Neurovascular Preservation of Patients Undergoing Reconstruction of Severed Finger under X-ray Image Examination.

OBJECTIVE: The study aimed to provide a guideline for continuous rehabilitation nursing for patients with severe finger replantation, and establish a satellite contact point for patients with severe finger replantation after discharge, so as to ensure scientific and effective rehabilitation training after discharge and explore the role of continuous rehabilitation nursing measurement in severe finger rehabilitation and neurovascular preservation. METHODS: A total of 380 patients accepting neurovascular preservation finger replantation in the hand surgery department were divided into an observation group and a control group according to the number of hospitalizations. All patients underwent reconstructive surgery of severed finger. X-ray filming was used to monitor the postoperative nursing effect of neurovascular preservation of severed finger. The discharged patient information questionnaire was filled 3 days before the discharge. Then, a patient information database was established, and rehabilitation training was performed. Finally, sexual rehabilitation nursing follow-up intervention, telephone follow-up, and cross-referring intervention were carried out. Postoperative x-ray images were taken regularly to observe the recovery of reconstructed finger. RESULTS: There was no difference in daily life ability scores and hand function scores between the 2 groups at discharge (P > 0.05). The daily life ability scores and hand function scores of the observation group were better than those of the control group at 1 and 6 months after discharge (P < 0.05), the difference is statistically significant. As the discharge time prolonged, the daily life ability score and hand function score of the 2 groups of patients gradually increased. X-ray images showed that the replanted finger body was well developed, phalanx was in good antithesis, and there was no epiphysis. CONCLUSIONS: Continuous rehabilitation nursing measures should be taken after the replantation of the severed finger after neurovascular preservation, which provides standardized rehabilitation training standards for patients with replantation of severed finger after discharge, improves patient training compliance, promotes hand function recovery as soon as possible, and enables patients to return to society as soon as possible, which is worthy of clinical promotion and application.

Fingertip injuries in children: a review of the literature.

Fingertip injuries in children are a common presentation in emergency settings. These injuries result from a variety of mechanisms with most occurring at home by crushing fingers in a door and are distressing for the child and parent or carer. It is essential that emergency clinicians respond competently and confidently. This article reviews the literature on the management of fingertip crush injuries to establish, where possible, best evidence. The article also describes the anatomy and assessment of the finger in relation to fractures of the distal phalanx, nail bed injury and subungual haematoma, and considers the use of antibiotics in the treatment of a subungual haematoma with a distal phalanx fracture.

Skin colour assessment of replanted fingers in digital images and its reliability for the incorporation of images in nursing progress notes.

AIMS AND OBJECTIVES: To determine whether nurses can accurately assess the skin colour of replanted fingers displayed as digital images on a computer screen. BACKGROUND: Colour measurement and clinical diagnostic methods for medical digital images have been studied, but reproducing skin colour on a computer screen remains difficult. DESIGN: The inter-rater reliability of skin colour assessment scores was evaluated. In May 2014, 21 nurses who worked on a trauma ward in Japan participated in testing. METHODS: Six digital images with different skin colours were used. Colours were scored from both digital images and direct patient's observation. The score from a digital image was defined as the test score, and its difference from the direct assessment score as the difference score. Intraclass correlation coefficients were calculated. Nurses' opinions were classified and summarised. RESULTS: The intraclass correlation coefficients for the test scores were fair. Although the intraclass correlation coefficients for the difference scores were poor, they improved to good when three images that might have contributed to poor reliability were excluded. Most nurses stated that it is difficult to assess skin colour in digital images; they did not think it could be a substitute for direct visual assessment. However, most nurses were in favour of including images in nursing progress notes. DISCUSSION: Although the inter-rater reliability was fairly high, the reliability of colour reproduction in digital images as indicated by the difference scores was poor. Nevertheless, nurses expect the incorporation of digital images in nursing progress notes to be useful. This gap between the reliability of digital colour reproduction and nurses' expectations towards it must be addressed. CONCLUSIONS: High inter-rater reliability for digital images in nursing progress notes was not observed. Assessments of future improvements in colour reproduction technologies are required. RELEVANCE TO CLINICAL PRACTICE: Further digitisation and visualisation of nursing records might pose challenges.

A closer look at hand and wrist complaints.

Hand or wrist pain is a common complaint in primary care. This pain can be very disabling and can significantly impair a person's quality of life. With the appropriate clinical knowledge and skills, nurse practitioners can effectively evaluate, diagnose, and treat many of the common hand and wrist complaints seen in primary care.

Techniques for removing rings from injured fingers.

Staff in emergency departments or minor injury units are sometimes asked to remove rings from patients' fingers. This is often because their presence has become painful or is preventing treatment of injuries or illnesses. Practitioners must be able to identify the tourniquet effect of rings or bracelets, and understand why and how they should be removed. This article describes the procedures that can be used.

The effectiveness of using a lipido-colloid dressing for patients with traumatic digital wounds.

This study compares the effect of a daily gauze dressing with that of a lipido-colloid dressing on the time taken to make up the dressing and efficacy of the management of traumatic digital wounds. This is a randomized controlled trial of 28 patients (16 experimental and 12 control) with injuries to their fingers and loss of tissue. The patients in the experimental and control groups were given a lipido-colloid dressing and a daily gauze dressing, respectively. The patients'wounds were assessed in terms of the size of the wound and the time it took for the wound to heal. The findings showed that patients in the experimental group had a faster recovery time from the healing of their wound than the control group (p= .024). The findings can help to establish an evidence-based practice in the management of traumatic digital wounds in clinical settings.

A dressing for the occasion? A comparative trial of two dressings for digit injuries.

Dressings for injured fingers and toes can be time-consuming and awkward to apply and painful to remove, and in busy A&E departments, speed and efficiency are paramount. This study compares traditional digit dressings with a new dressing which claims to address all these problems.

Replantation of digits.

Replantation surgery has come of age in the past 20 years. Sophisticated microsurgical techniques, improved preservation methods, and increased understanding of ischemia time have all contributed to the growth of digital replantation as a viable surgical process. The complexity of the surgeries warrants a review of nursing management, pharmacologic modalities, and monitoring alternatives. This article explores rehabilitative therapies in relation to successful patient outcomes.