Plastic surgical nursing : official journal of the American Society of Plastic and Reconstructive Surgical Nurses
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Successful patient outcomes from an operative procedure require vigilance, diligence, and teamwork among the various providers involved with the surgical procedure. An understanding of the responsibilities and appreciation for the complexities of each healthcare provider's role in the operative process is essential to a harmonious relationship among the perioperative team to improve the working environment and provide safe patient care. The information provided in this article is based on commonly observed practices in the anesthesia community with the caveat that the choices can vary considerably and are influenced by patient presentation and surgical requirements.
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Effective postoperative analgesia is a prerequisite to enhance the recovery process and reduce morbidity. The use of local anesthetic techniques is well documented to be effective, but single-dose techniques (infiltration, peripheral blocks, neuraxial blocks) have been of limited value in major operations because of their short duration of analgesia. ⋯ This therapy transmits gentle, short bursts of electrical current targeted to the tissue cells at the surgical site. This article reviews recent clinical experience and evidence of this device in plastic and reconstructive surgery.
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For surgical patients, postoperative nausea and vomiting (PONV) is one of the most undesired complications of anesthesia and surgery.
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Exudate consists of fluid and leukocytes that move to the site of injury from the circulatory system in response to local inflammation. This inflammatory response leads to blood vessel dilatation and increased permeability, resulting in increased production of exudate. The nature and quantity of exudate depend on the nature and severity of the tissue damage. ⋯ This moisture balance is essential to promote healing and is oftentimes a major challenge to the wound care provider. This article will explore the benefits of wound fluid as well as the detrimental impact on wound healing. Assessment and management will also be briefly discussed.
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Plastic surgeons and their support staff are tasked with proficient management of a wide variety of complex wounds. Since its introduction, negative pressure wound therapy (NPWT) has increasingly been used within the plastic surgery specialty to improve and simplify wound management. Increased usage of the therapy has prompted the development of a myriad of new NPWT systems. ⋯ Wound-specific NPWT systems of varying size are available for low- to moderate-severity wounds, clean closed incisions, and acute abdominal wounds. Wound size and severity, amount of exudate, and patient mobility issues have become important considerations when choosing an NPWT device. The purpose of this article is to familiarize the reader with the latest sophistications in NPWT systems to guide decision making and usage.