Mene Aniruddh, Biswas Gautam, Parashar Atul, Bhattacharya Anish
Aniruddh Mene, Gautam Biswas, Atul Parashar, Department of Plastic Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
World J Crit Care Med. 2016 Nov 4;5(4):228-234. doi: 10.5492/wjccm.v5.i4.228.
To look into the management options of early debridement of the wound, followed by vascularized cover to bring in fresh blood supply to remaining tissue in electrical burns.
A total of 16 consecutive patients sustaining full thickness forearm burns over a period of one year were included in the study group. Debridement was undertaken within 48 h in 13 patients. Three patients were taken for debridement after 48 h. Debridement was repeated within 2-4 d after daily wound assessment and need for further debridement.
On an average two debridements (range 1-4) was required in our patients for the wound to be ready for definitive cover. Interval between each debridement ranged from 2-18 d. Fourteen patients were provided vascularized cover after final debridement (6 free flaps, 8 pedicled flaps). Functional assessment of gross hand function done at 6 wk, 2 mo, 3 mo and 6 mo follow-up.
High-tension electrical burns lead to significant morbidity. These injuries are best managed by early decompression followed by multiple serial debridements. The ideal timing of free flap coverage needs further investigation.
探讨早期伤口清创，随后采用带血管蒂覆盖物为电烧伤后剩余组织提供新鲜血液供应的处理方法。
研究组纳入连续1年期间共16例全层前臂烧伤患者。13例患者在48小时内进行清创。3例患者在48小时后进行清创。每日伤口评估及确定需要进一步清创后，在2 - 4天内重复清创。
平均每位患者需要进行两次清创（范围1 - 4次）以使伤口准备好进行确定性覆盖。每次清创间隔时间为2 - 18天。14例患者在最终清创后采用带血管蒂覆盖物（6例游离皮瓣，8例带蒂皮瓣）。在6周、2个月、3个月和6个月随访时对手部总体功能进行功能评估。
高压电烧伤导致显著的发病率。这些损伤最好通过早期减压，随后进行多次连续清创来处理。游离皮瓣覆盖的理想时机需要进一步研究。
