Basu Sandip Kanti, Bain Jayanta, Chattopadhyay Debarati, Majumdar Bijay Kumar
Department of Plastic Surgery, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India.
Department of Plastic Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
J Indian Assoc Pediatr Surg. 2017 Jan-Mar;22(1):43-45. doi: 10.4103/0971-9261.194621.
Extensive electric burn around the chest in children is rare and this type of injury always poses a great challenge for its management. A 12-year-old male child with extensive electric burn of the chest wall was admitted to hospital. It was a neglected case of 9 days old burn; the young boy was in critical condition having systemic features of toxemia with widespread necrosis of the skin, subcutaneous tissues, and muscles along with exposed bones (ribs and sternum) with the risk of impending rupture of pleura through the exposed intercostal spaces. After initial resuscitation, a thorough debridement of all necrotic tissues was done. Thereafter, a superiorly based vertical rectus abdominis myocutaneous flap was harvested to cover the exposed bones and intercostal spaces. The remaining raw areas were skin grafted. The child made an excellent recovery with good outcome.
儿童胸部大面积电烧伤较为罕见，这类损伤的治疗始终是一项巨大挑战。一名12岁男性儿童因胸壁大面积电烧伤入院。这是一例被忽视的9日龄烧伤病例；小男孩病情危急，出现毒血症的全身症状，皮肤、皮下组织和肌肉广泛坏死，伴有肋骨和胸骨等骨骼外露，存在通过肋间间隙导致胸膜即将破裂的风险。经过初步复苏后，对所有坏死组织进行了彻底清创。此后，切取了一块以头端为蒂的腹直肌肌皮瓣来覆盖外露骨骼和肋间间隙。其余创面进行了植皮。患儿恢复良好，预后极佳。
