Systematic Evaluation of Medical & Nursing Care in Cardiovascular Injuries Patients with Burn and Bone Fracture Candidate Plastic Restorative

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Azin Hasani, Masoumeh Sinaei, Payam Hoshyar Azar, Atefeh Ranjbar, Majid Khalilizad

Abstract

This study has investigated and systematically evaluated cardiovascular injuries in burn and bone fracture patients who are candidates for plastic surgery with nursing and medical points. When the fracture is accompanied by the damage of a large artery, the case should be considered an emergency because the effects quickly become irreversible. In cases of severe vascular symptoms (pulsatile hematoma, severe bleeding, acute limb ischemia), emergency surgery including fracture reduction and fixation and vascular repair is required. Fractures are fixed with internal fixation or usually with external fixator. First, the vessels should be repaired and then the fracture should be stabilized, unless the fracture is unstable and its reduction requires a severe maneuver, in which case the fracture should be stabilized first to prevent damage to the vascular sutures. Open fracture with severe contamination and irreparable artery severance, ischemia time longer than 8 hours, soft tissue crush, old age and high probability of vascular repair failure. In cases of prolonged ischemia and the possibility of compartment syndrome, decompression and fasciotomy of the leg compartment are performed. The time interval between the accident and the repair of the artery is the most important factor in the prognosis. If the ischemia time is less than 8 hours, the probability of amputation is 20-25%, and if the ischemia time is longer than 8 hours, this probability reaches 50%.

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