1例4岁儿童多发伤合并大面积撕脱伤的手术护理配合

Surgical Nursing Cooperation of a 4-Year-Old Child with Multiple Injuries and Extensive Avulsion Injury

摘要: 目的：总结1例4岁儿童车祸多发伤合并大面积撕脱伤的手术护理配合经验。方法：2025年7月海军军医大学战创伤中心收治1例4岁车祸多发伤合并上肢大面积撕脱患儿，回顾性分析并总结患儿的临床资料。术前快速启动战创伤急救绿色通道，多学科联合会诊，做好患儿心理安抚与术前准备；术中专人团队精准配合清创、撕脱皮肤复位及损伤组织修复操作，注重体温、循环及疼痛管理；术后加强转运安全与交接管理。结果：经过反复手术的精心治疗与护理，患儿多次手术顺利完成，术后恢复良好，未出现护理相关并发症。结论：针对儿童多发伤合并撕脱伤需多次手术患者，手术室护士需具备快速应急能力与精细化团队护理思维，通过多学科协同与个体化护理措施，可有效保障手术安全与预后。

Abstract: Objective: To summarize the experience of surgical nursing cooperation in a 4-year-old child with multiple injuries and extensive avulsion. Methods: In July 2025, a 4-year-old child with multiple injuries in a car accident and extensive upper limb avulsion was admitted to the War Trauma Center of Naval Medical University, and the clinical data of the child were retrospectively analyzed and summarized. The medical team promptly activated the emergency fast-track pathway for children with war-related injuries, convened a multidisciplinary consultation, and provided psychological support and appropriate preoperative preparation; During the operation, a dedicated team cooperated with debridement, avulsion skin reduction and damaged tissue repair accurately, and paid attention to temperature, circulation and pain management. Postoperatively, the team should ensure the patient’s safe transfer and provide a thorough handover. Results: After careful treatment and nursing of repeated operations, the child successfully completed many operations, recovered well after operation, and no nursing-related complications occurred. Conclusion: For children with multiple injuries and avulsion injuries who need multiple operations, operating room nurses should have the ability of rapid emergency and meticulous team nursing thinking. Through multidisciplinary collaboration and individualized nursing measures, the safety and prognosis of operations can be effectively guaranteed.