Postoperative care for congenital absence of vagina

There are many surgical treatments for congenital absence of vagina, and the first choice is sigmoid colon vaginoplasty. The surgical method is to open the rectal vesical gap to "create a hole", then take a section of sigmoid colon and insert it into the vagina in reverse to fix it. It sounds simple, but it is not 100% successful. So what are the postoperative care for congenital absence of vagina?

1. Body position: Place the patient in an appropriate position according to the anesthesia and surgical site.

2. Observation of the condition:

①Measure blood pressure, pulse, respiration and body temperature regularly, pay attention to the patient's complexion, peripheral circulation, urine volume, consciousness, etc. If any abnormality is found, notify the doctor in time. ②Closely observe the incision, keep the dressing clean and dry, etc., and closely observe the wound skin for signs of infection such as redness, swelling, heat, pain, etc. 3 days after the operation.

③ Take good care of various pipelines: timely mark, properly fix, keep them unobstructed, observe them daily,

Record the color, nature and amount of drainage fluid, and flush according to doctor's instructions when necessary.

④Observe the amount, properties, and infection of vaginal secretions, and control the time of the first bowel movement. ⑤Those who use an analgesic pump should closely observe its effects and listen carefully to the patient's complaints.

⑥ Teach the patient how to replace the vaginal model. When the vaginal model is replaced for the first time, the wound has not healed completely and the patient will feel obvious pain. Painkillers are often required within half an hour of the replacement. The nurse should accompany the patient at the bedside, hold the patient's hand, assist the doctor in placing the vaginal model, and fix it with a T-belt. The vaginal model should be of appropriate size and lubricant should be applied to the model to relieve pain.

3. Medication status: drug name, drug effects and adverse reactions, etc.

4. Diet: Patients should be guided to eat a reasonable diet according to the doctor's advice and pay attention to the time of the first bowel movement. 5. Activities, rest and functional exercise:

① Rest in bed and gradually increase the amount and range of activity according to the condition. ② Provide basic nursing and specialist nursing:

Keep the ward clean. Take good care of the vulva, keep it clean and dry, change the perineal pad frequently, and use 0.2 iodine cotton balls to clean the vulva 1-2 times a day to prevent infection. ③ Encourage patients to eat properly to prevent constipation and control the time of the first bowel movement. Encourage patients to move their upper body and upper limbs to prevent pressure sores.

6. Psychological care: Continue to provide psychological support to patients and their families after surgery.