ASSESSMENT EXPLANATION OBJECTIVES

INTERVENTIONS RATIONALE OUTCOME

S -
"Nag motor ako
tapos nadisgrasya
ko yung paa ko"

O -
>Localized injury
over bony
prominence; stage
4 ulcer

>Disruption of
skin at right foot




>Wound is around
120 mm in diameter


Nursing Dx:

Impaired skin
integrity related
to






ASSESSMENT EXPLANATION OBJECTIVES


INTERVENTIONS RATIONALE OUTCOME

S -
"Nag motor ako
tapos nadisgrasya
ko yung paa ko"

O -
>Localized injury
over bony
prominence; stage
4 ulcer

>Disruption of
skin on lower
extremity









>Wound is around
120 mm in diameter


Nursing Dx:

Impaired skin
integrity related
to



PROCEDURE AND PATHOPHYSIOLOGY
The mangled extremity deserves special mention owing to the
tremendous complexity of care and the great potential for
associated complications. These devastating injuries are those
with concomitant soft tissue, bony, vascular, and often nervous
injury, They are seen with farm machinery and industrial
mishaps, high speed motorcycle crashes, and in explosive combat
injuries and mostly involves the lower leg and foot.
The surgery involves re-setting the metatarsal bone,
pinning the bone in place, and allowing the surgical site to
heal. Once the foot heals from metatarsal surgery, patients
typically experience relief from pain and improved foot
functionality.
Reasons for metatarsal surgery
Metatarsal surgery can be used to correct a number of foot
problems, including:
Bunion deformities.
Calluses on the bottom of the foot or ball of the foot.
Foot problems caused by rheumatoid arthritis, diabetes, and
certain other diseases.
Metatarsal fractures.




Pinning - The metatarsal surgery procedure

Metatarsal surgery is an outpatient procedure performed while
the patient is anesthetized (usually via intravenous sedation or
general anesthesia).

He then incises the bone, places it in its proper position, and
pins it in place with a metal pin or screw. Finally, he stitches
the incision. (The doctor may also remove any foot calluses and
correct any other problems if necessary.)


After the metatarsal surgery procedure, most patients wear a
cast and use crutches for approximately six to eight weeks,
while the bone and skin tissues heal. Patients may resume normal
activities once the surgical site heals completely









INSTRUMENTS
1) Driller
- Cutting and drilling into bone. Drills the pin
into bone. May be used in manual or power drill



2) Metal Pin
-Attached to the driller which helps in pinning
the bone in place.


3) DeBakey Tissue Forceps
-Grasps numerous types of tissue; commonly used in cardiac and
vascular surgery


4) Mayo scissors
- When cutting suture, use the tips of the scissors. 5) Metzenbaum
scissors
- Dissect and undermine delicate tissue



6) Backhaus towel clamp
-Used for holding towels in place when draping, when
grasping tough tissue, and during reduction of small bone
fractures.


7) Crile forceps/clamps, curved or straight
-Used to occlude bleeders before cauterization or
ligation.