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腹部电烧伤

Electrical burns of the abdomen.

作者信息

Srivastava Rakesh Kumar, Kumar Ritesh

机构信息

Department of Burns & Plastic Surgery, Safdarjung Hospital, New Delhi, India.

出版信息

Indian J Plast Surg. 2013 Sep;46(3):587-90. doi: 10.4103/0970-0358.122028.

Abstract

A 35-year-old male farmer came in contact with 11,000 volts high tension electric wire and sustained full thickness burn wounds over scapula, upper limb and anterior abdominal wall along with perforation of the intestine. Patient was initially managed conservatively in general surgery ward and was referred to us after 3 days with necrosis of the burned skin and muscles over the shoulder and abdomen. Patient was initially managed conservatively and then thorough debridement of the necrotic skin over the left shoulder and upper arm was done and the area was split skin grafted. Patient developed enterocutaneous fistula, which healed over a period of 8 weeks. The granulating wound over the abdomen was also skin grafted and patient was discharged after 18 days. About 4 months, after the discharge patient presented with ventral hernia. Repair of ventral hernia by synthetic mesh application and reconstruction of the abdominal wall with a free tensor fascia lata flap was done over the mesh, but the flap failed. Then after debridement two random pattern transposition skin flaps, one from the right upper and another from the left lower abdomen were transposed over the abdominal wound and donor area was skin grafted. Patient was discharged after 17 days.

摘要

一名35岁男性农民接触了11000伏的高压电线,导致肩胛骨、上肢和前腹壁全层烧伤,并伴有肠穿孔。患者最初在普通外科病房接受保守治疗,3天后因肩部和腹部烧伤皮肤及肌肉坏死被转诊至我院。患者最初接受保守治疗,随后对左肩和上臂的坏死皮肤进行了彻底清创,并对该区域进行了中厚皮片移植。患者出现肠皮肤瘘,8周后愈合。腹部肉芽创面也进行了植皮,患者18天后出院。出院约4个月后,患者出现腹疝。通过应用合成补片修复腹疝,并在补片上用游离阔筋膜张肌皮瓣重建腹壁,但皮瓣失败。然后在清创后,将两块随意型易位皮瓣,一块取自右上腹,另一块取自左下腹,转移至腹部伤口,并对供区进行植皮。患者17天后出院。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ab3/3897111/f8a0d505ff68/IJPS-46-587-g001.jpg

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