S - "Nag motor ako tapos nadisgrasya ko yung paa ko"
O - >Localized injury over bony prominence; stage 4 ulcer
>Disruption of skin at right foot
>Wound is around 120 mm in diameter
Nursing Dx:
Impaired skin integrity related to
ASSESSMENT EXPLANATION OBJECTIVES
INTERVENTIONS RATIONALE OUTCOME
S - "Nag motor ako tapos nadisgrasya ko yung paa ko"
O - >Localized injury over bony prominence; stage 4 ulcer
>Disruption of skin on lower extremity
>Wound is around 120 mm in diameter
Nursing Dx:
Impaired skin integrity related to
PROCEDURE AND PATHOPHYSIOLOGY The mangled extremity deserves special mention owing to the tremendous complexity of care and the great potential for associated complications. These devastating injuries are those with concomitant soft tissue, bony, vascular, and often nervous injury, They are seen with farm machinery and industrial mishaps, high speed motorcycle crashes, and in explosive combat injuries and mostly involves the lower leg and foot. The surgery involves re-setting the metatarsal bone, pinning the bone in place, and allowing the surgical site to heal. Once the foot heals from metatarsal surgery, patients typically experience relief from pain and improved foot functionality. Reasons for metatarsal surgery Metatarsal surgery can be used to correct a number of foot problems, including: Bunion deformities. Calluses on the bottom of the foot or ball of the foot. Foot problems caused by rheumatoid arthritis, diabetes, and certain other diseases. Metatarsal fractures.
Pinning - The metatarsal surgery procedure
Metatarsal surgery is an outpatient procedure performed while the patient is anesthetized (usually via intravenous sedation or general anesthesia).
He then incises the bone, places it in its proper position, and pins it in place with a metal pin or screw. Finally, he stitches the incision. (The doctor may also remove any foot calluses and correct any other problems if necessary.)
After the metatarsal surgery procedure, most patients wear a cast and use crutches for approximately six to eight weeks, while the bone and skin tissues heal. Patients may resume normal activities once the surgical site heals completely
INSTRUMENTS 1) Driller - Cutting and drilling into bone. Drills the pin into bone. May be used in manual or power drill
2) Metal Pin -Attached to the driller which helps in pinning the bone in place.
3) DeBakey Tissue Forceps -Grasps numerous types of tissue; commonly used in cardiac and vascular surgery
4) Mayo scissors - When cutting suture, use the tips of the scissors. 5) Metzenbaum scissors - Dissect and undermine delicate tissue
6) Backhaus towel clamp -Used for holding towels in place when draping, when grasping tough tissue, and during reduction of small bone fractures.
7) Crile forceps/clamps, curved or straight -Used to occlude bleeders before cauterization or ligation.