Application of meticulous nursing intervention in patients with perineal scar repair

Objective To explore the clinical effect of refined nursing intervention in patients with perineal scar repair. Methods A total of 132 patients with perineal scars who underwent skin flap repair in the Department of Burns and Plastic Surgery, First People′s Hospital of Kunshan from June 2014 to July 2017 were selected. They were divided into the control group and the intervention group according to random number table method, 66 patients in each group. Patients in the control group were given routine nursing; patients in the intervention group received preoperative refinement psychology, skin and intestinal care, surgical design and image data collection and postural training, and after the operation, they received refinement anesthesia, brake, wound care, diet, anti-drug guidance and other nursing interventions. The healing time and postoperative complications of the two groups were recorded. The changes of pain, itching and mood (depression, anxiety) before and after treatment were observed. Nursing satisfaction and total recovery rate of two groups were evaluated. The data were processed with the independent sample t test, the paired sample t test and chi-square test. Results Compared with the control group[(37.2±5.3) d], the healing time of the repaired area was significantly shortened in the intervention group [(21.6±3.1) d], the difference was statistically significant (t=6.848, P<0.05). The incidence of complications in the intervention group was 4.55%(3/66), which was significantly lower than the control group [22.73% (15/66)](χ2=7.784, P<0.05). There were no statistically significant differences in the scores of pain, itching, depression and anxiety between the control group and the intervention group before nursing (with P values above 0.05); after nursing, the scores of patients in both groups were lower than those before nursing, and the differences were statistically significant (with P values below 0.05). The scores of pain, itching, depression and anxiety after nursing in the intervention group were (2.4±0.6), (4.5±1.3), (6.9±2.6), (8.6±2.5) points, the scores of the control group were (4.5±1.2), (6.6±1.1), (11.5±3.4), (2.9±3.8) points, the differences between the two groups were statistically significant (t=5.421, 5.663, 7.136, 8.205; P=0.022, 0.017, 0.006, 0.002). The scores of effective, reasonable, comprehensive and scientific aspects of the intervention group [(11.3±0.8), (22.7±1.8), (22.1±2.7), (22.7±4.1) points] were significantly higher than those of the control group [(6.6±1.5), (19.2±3.3), (18.5±3.6), (17.9±3.8) points] (t=8.844, 6.811, 7.542, 7.916, P=0.007, 0.024, 0.018, 0.014). The total excellent and good rate of repair in the intervention group [96.97%(64/66)]was significantly higher than that in the control group [84.85%(56/66)] (χ2=4.492, P=0.034). Conclusion The meticulous nursing intervention of patients with perineal scar repair flap repair can effectively improve the excellent rate and safety. Key words: Nursing care; Intervention studies; Perineum; Cicatrix; Repair