title: Nursing monitoring and management of free and pedicled flaps--outcomes of teaching sessions on flap care.
abstract: BACKGROUND
  Close monitoring is crucial following successful flap surgery because early detection of signs of deterioration can result in a successful intervention and salvage of the flap. An observational audit of practice highlighted short comings in flap monitoring in our Plastic Surgery unit. We created and delivered a teaching session to junior nursing staff with regard the basic principles of flaps and their postoperative care and generated a universal postoperative flap monitoring protocol to help improve and standardize care provision.
  
  
  METHODS
  Following a group teaching session, all healthcare providers provided input to create a flap monitoring chart. A cartoon was drawn and placed around the ward to consolidate the ideas generated.
  
  
  RESULTS
  The working relationship between doctors and nurses on the ward improved dramatically. Nursing staff felt more confident in their ability to deal with flaps postoperatively and felt more able to contact the surgeons about any concerns or clarifications needed. A re-audit of procedures following these interventions showed improvement in detection of flap ischemia.
  
  
  CONCLUSIONS
  Good patient care within any healthcare system is entirely dependent on the effective function of the multidisciplinary team while maintaining the patient as the focus of care. With both subjective and objective evidences of improvement in the care of flaps in our Plastic Surgery Unit, we can confidently conclude that our teaching program and postoperative flap protocol has been a successful intervention.
authors.affiliation: Department of Plastic Surgery, University Hospital North Staffordshire, Stoke-on-Trent, UK.
authors.forename: Muhammad Adil Abbas
authors.initials: MA
authors.lastname: Khan
authors.forename: Arvind
authors.initials: A
authors.lastname: Mohan
authors.forename: Waseem
authors.initials: W
authors.lastname: Ahmed
authors.forename: Sukh
authors.initials: S
authors.lastname: Rayatt
mesh_terms: D004493:Education; D058752:Free Tissue Flaps / Q000009:adverse effects; D006801:Humans; D007318:Inservice Training; D009730:Nursing Assessment; D011182:Postoperative Care / Q000193:education / Q000451:nursing*; D019651:Plastic Surgery Procedures / Q000193:education / Q000451:nursing*; D013524:Surgical Flaps / Q000009:adverse effects