Shen Yu-ming, Tian Peng, Ning Fang-gang, Qin Feng-jun, Zhang Guo-an
Department of Burns, Beijing Jishuitan Hospital, Beijing, China.
Zhonghua Shao Shang Za Zhi. 2012 Dec;28(6):408-10.
To explore the method for repairing circumferential wound in the wrist region due to high-voltage electrical burn.
Six patients with circumferential wound in the wrist region after high-voltage electrical burn were admitted to our hospital from January 2009 to December 2011. After debridement, wounds in the wrist were repaired with combined abdominal axial pattern flaps. The wound of wrist on the flexor aspect was repaired with paraumbilical flap carrying a portion of rectus abdominis that filled the wound cavity of the wrist on the flexor aspect. The wound of wrist on the dorsal aspect was repaired with lower abdominal flap. Pedicle division was performed 4 - 5 weeks post surgery. Some donor sites were sutured directly, and the others were closed by skin grafting after the suture of anterior sheath.
Three flaps survived. Liquefaction necrosis of tissue was observed under two flaps, and they were healed after debridement. Radial artery embolism of wrist occurred in one flap when pedicle division was performed 5 weeks post surgery, and it was healed by a transplantation of a segment of the great saphenous vein to reconstruct radial artery right after debridement. Patients were followed up for 6 - 12 months, and satisfactory appearance and function of the flaps were observed.
It is a feasible option to repair circumferential wound in the wrist region due to high-voltage electrical burn by using paraumbilical flap carrying a portion of rectus abdominis muscle combined with lower abdominal flap.
探讨高压电烧伤致腕部环形创面的修复方法。
2009年1月至2011年12月收治6例高压电烧伤后腕部环形创面患者。清创后，采用腹部轴型皮瓣联合修复腕部创面。腕部掌侧创面采用携带部分腹直肌的脐旁皮瓣修复，填充腕部掌侧创面腔隙。腕部背侧创面采用下腹壁皮瓣修复。术后4～5周断蒂。部分供区直接缝合，部分供区在缝合前鞘后行植皮封闭。
3块皮瓣存活。2块皮瓣下出现组织液化坏死，清创后愈合。1块皮瓣术后5周断蒂时发生腕部桡动脉栓塞，清创后立即移植一段大隐静脉重建桡动脉而愈合。患者随访6～12个月，皮瓣外观及功能满意。
采用携带部分腹直肌的脐旁皮瓣联合下腹壁皮瓣修复高压电烧伤致腕部环形创面是一种可行的选择。
