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Nursing Monitoring and Management of Free and Pedicled Flaps—Outcomes of Teaching Sessions on Flap Care

Khan, Muhammad Adil Abbas MBBS, MRCS, DOHNS; Mohan, Arvind MBBS, BMedSci; Ahmed, Waseem MBBS, DOHNS; Rayatt, Sukh FDS, FRCS (plast)

doi: 10.1097/PSN.0b013e3181fd4a85
ARTICLES: CONTINUING EDUCATION
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CE

Background: Close monitoring is crucial following successful flap surgery because early detection of signs of deterioration can result in a successful intervention and salvage of the flap. An observational audit of practice highlighted short comings in flap monitoring in our Plastic Surgery unit. We created and delivered a teaching session to junior nursing staff with regard the basic principles of flaps and their postoperative care and generated a universal postoperative flap monitoring protocol to help improve and standardize care provision.

Methods: Following a group teaching session, all healthcare providers provided input to create a flap monitoring chart. A cartoon was drawn and placed around the ward to consolidate the ideas generated.

Results: The working relationship between doctors and nurses on the ward improved dramatically. Nursing staff felt more confident in their ability to deal with flaps postoperatively and felt more able to contact the surgeons about any concerns or clarifications needed. A re-audit of procedures following these interventions showed improvement in detection of flap ischemia.

Discussion: Good patient care within any healthcare system is entirely dependent on the effective function of the multidisciplinary team while maintaining the patient as the focus of care. With both subjective and objective evidences of improvement in the care of flaps in our Plastic Surgery Unit, we can confidently conclude that our teaching program and postoperative flap protocol has been a successful intervention.

Muhammad Adil Abbas Khan, MBBS, MRCS, DOHNS, is Specialist Registrar in Plastic Surgery, Department of Plastic Surgery, University Hospital North Staffordshire, Stoke-on-Trent, United Kingdom.

Arvind Mohan, MBBS, BMedSci, is Senior House Officer in Plastic Surgery, Department of Plastic Surgery, University Hospital North Staffordshire, Stoke-on-Trent, United Kingdom.

Waseem Ahmed, MBBS, DOHNS, is Senior House Officer in ENT, Department of Plastic Surgery, University Hospital North Staffordshire, Stoke-on-Trent, United Kingdom.

Sukh Rayatt, FDS, FRCS (plast), is Consultant Plastic Surgeon, Department of Plastic Surgery, University Hospital North Staffordshire, Stoke-on-Trent, United Kingdom.

Address correspondence to Arvind Mohan, MBBS, BMedSci, Department of Plastic Surgery, University Hospital North Staffordshire, Stoke-on-Trent ST4 7LN, United Kingdom (e-mail: arvind_383@hotmail.com).

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Copyright © 2010 by American Society of Plastic Surgical Nurses