Surgical Treatment

Subject: Medical and Surgical Nursing I (Theory)

Overview

A surgical treatment called reduction is used to realign a fracture or dislocation. Open or closed methods of reduction are both possible. The term "open reduction" describes a surgical procedure in which the fracture pieces are made visible by cutting open the tissues. A cast is typically placed after a closed reduction, which involves manipulating the fracture without making an incision and either using fluoroscopy, a type of x-ray system, or only by feel. Amputation refers to the removal of a limb due to injury, disease, or surgery. It is used surgically to manage pain or a disease condition in the affected limb, such as gangrene or cancer. Following surgical treatment, keep an eye out for any systemic signs of excessive blood loss, such as widening pulse pressure, tachycardia, and decreased a level of consciousness. Administer prescribed medications as needed to control post-operative pain.
  • Reduction: - Closed and open reduction
  • Amputation

Reduction 

A surgical treatment called reduction is used to realign a fracture or dislocation. The loss of alignment during a bone fracture manifests as displacement or angulation of the fragments. The bony fragments must be placed back in their anatomical positions for the fractured bone to heal without deforming.

Reduction could be by closed or open methods

  • Open reduction: The term "open reduction" describes a surgical procedure in which the fracture pieces are made visible by cutting open the tissues. Making an incision in the skin, joining the broken bones, and stabilizing them with screws, plates, or rods constitute the open reduction of a fracture. Because the fragments are held together when open, healing is frequently quicker.
  • Closed reduction:  A cast is typically placed after a closed reduction, which involves manipulating the fracture without making an incision and either using fluoroscopy, a type of x-ray system, or only by feel. The benefit of close is that surgery is avoided, but because the bones are not firmly held together, healing may take longer.
  • Amputation: Amputation refers to the removal of a limb due to injury, disease, or surgery. It is used surgically to manage pain or a disease condition in the affected limb, such as gangrene or cancer. It is sometimes performed on people as a preventative surgery for these issues. Congenital amputation, a congenital disorder in which fetal limbs have been amputated by constrictive bands, is a unique instance.

Types of Amputation

  • Closed amputation
  • Open amputation
  • Minor amputation
  • Major amputation
  • Self-amputation
  • Traumatic amputation

Indication

  • Injury
  • Bone infection
  • Vascular disease of the periphery
  • Gas gangrene that is fulminating
  • Tumors
  • Nerve injuries
  • Congenital anomalies
  • Neoplasm
  • Deformities
  • Circulatory disorder

Nursing intervention

  • Keep an eye out for systemic signs of significant blood loss, hypotension, a broadening pulse, tachycardia, and a loss of consciousness in your patients.
  • Elevate the residual limb to encourage venous return and apply an air splint, if recommended, to reduce swelling.
  • Accept patient reactions to body part loss (i.e. depression, withdrawal, denial frustration)
  • Be aware that a hematoma, an infection, or necrosis may be present if your discomfort keeps getting worse.
  • Examine the patient for pain.
  • As needed, give prescription drugs to treat post-operative pain.
  • Encourage the patient to move around in bed frequently.
  • Use physical modalities, such as wrapping or temperature change, as directed, to ease pain-related discomfort.
  • Prevent postural irregularities and deformities such hip flexion contracture.
  • Teach the patient's family how to shape the residual limb into a conical shape for prosthesis fitting by wrapping it in an elastic bandage to control swelling.

 References

  • A Textbook of Adult Health Nursing (2nd ed.). Mandal, G. (August 2013).  Dilllibazar kathmandu: Makalu publication house. Retrieved August 2013
  • answers.yahoo.com/question/index?qid=20070308210440AA08ji8
  • coursehero.com › Medical College › DHYG › DHYG 3250
  • revolvy.com/main/index.php?s=Amputate&item_type=topic
  • quizlet.com/125858020/med-surg-musculoskeletal-part-1-flash-cards/
Things to remember
  • A surgical treatment called reduction is used to realign a fracture or dislocation.
  • Amputation refers to the removal of a limb due to injury, disease, or surgery.
  • Types of amputation include closed, open, minor, etc.
  • Elevate the residual limb to encourage venous return and, if prescribed, use an air splint.
  • Examine the patient for pain.
  • Prevent postural irregularities and deformities like hip flexion contracture.
Questions and Answers

Reduction

A surgical procedure called reduction is used to realign a fracture or dislocation. The loss of alignment during a bone fracture manifests as displacement or angulation of the fragments. The bony fragments must be placed back in their anatomical positions for the fractured bone to heal without deforming.

Amputation:

Amputation refers to the removal of a limb due to injury, disease, or surgery. It is used surgically to manage pain or a disease condition in the afflicted limb, such as gangrene or cancer. It is sometimes performed on people as a prophylactic procedure for these issues. Congenital amputation, a congenital condition in which embryonic limbs have been amputated by constrictive bands, is a unique instance.

Types of Amputation

  • Closed Amputation,
  • Open Amputation,
  • Minor Amputation,
  • Major Amputation,
  • Self-amputation,
  • Traumatic Amputation.

Nursing Intervention

Keep an eye out for systemic signs of significant blood loss, hypotension, a broadening pulse, tachycardia, and a loss of consciousness in your patients.

  • Elevate the residual limb to encourage venous return and apply an air splint, if recommended, to reduce swelling.
  • Accept patient reactions to body part loss (i.e. depression, withdrawal, denial frustration)
  • Be aware that a hematoma, an infection, or necrosis may be present if your discomfort keeps getting worse.
  • Examine the patient for discomfort.
  • As needed, give prescription medications to control post-operative pain.
  • Encourage the patient to move around in bed frequently.
  • Use physical modalities, such as wrapping or temperature change, as directed, to ease pain-related discomfort.
  • Prevent postural irregularities and deformities like hip flexion contracture.
  • Teach patient and family how to wrap residual limb with an elastic bandage to control edema and to form a conical shape for prosthesis fitting.

 

 

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