Shen Y M, Chen X, Zhang C, Wang C, Qin F J, Ma C X, Hu X H
Department of Burns, Beijing Jishuitan Hospital, Beijing 100035, China.
Zhonghua Shao Shang Za Zhi. 2017 Jul 20;33(7):422-425. doi: 10.3760/cma.j.issn.1009-2587.2017.07.006.
To investigate the effects of flow-through descending branch of lateral circumflex femoral artery flap on repairing high-voltage electrical burn wounds of wrist of patients. From January 2014 to June 2016, 5 patients with high-voltage electrical burn of unilateral wrist were hospitalized in our burn ward, with extensive necrosis of skin soft tissue of burn wrist. Five patients were transferred to our burn ward 6 to 12 days post injury after undergoing emergency dermotomy of wrist to reduce tension in other hospitals. In 2 to 3 days after admission, operation was performed by two surgeon group at the same time, when patients' general condition were stable. One group underwent debridement and the other group designed and dissected flap according to the range of skin soft tissue defect of wrist. Wrist wounds after debridement ranged from 15 cm×10 cm to 24 cm×15 cm. Three patients were treated with flow-through descending branch of lateral circumflex femoral artery flap and great saphenous vein for repairing wounds of wrist and reconstruction of ulnar and radial artery. Two patients were treated with flow-through descending branch of lateral circumflex femoral artery flap for repairing wounds of wrist and reconstruction of ulnar artery. The dissected flaps ranged from 16 cm×12 cm to 26 cm×16 cm and the length of bridging vessel ranged from 15 to 21 cm. The flow-through descending branch of lateral circumflex femoral artery flaps of five patients survived well. Wounds of 4 patients healed and wounds of 1 patient with infection under the flap on 3 days after operation healed after changing wound dressing and undergoing debridement for 2 weeks. After the operation, wrists and hands of 5 patients had adequate blood supply and ulnar and radial artery recovered patency. Follow-up of patients for 6 months to 1 year showed good flap appearance and adequate blood supply of burn hands. The flow-through descending branch of lateral circumflex femoral artery flap can repair wrist wounds and recover blood supply of hands and it is a good method for repairing high-voltage electrical burns of wrist.
探讨旋股外侧动脉降支穿支皮瓣修复患者腕部高压电烧伤创面的效果。2014年1月至2016年6月，5例单侧腕部高压电烧伤患者入住我院烧伤病房，腕部皮肤软组织广泛坏死。5例患者受伤后6至12天在其他医院行腕部急诊减张切开术后转入我院烧伤病房。入院后2至3天，待患者一般情况稳定时，由两组手术医生同时进行手术。一组行清创术，另一组根据腕部皮肤软组织缺损范围设计并切取皮瓣。清创后腕部创面大小为15 cm×10 cm至24 cm×15 cm。3例患者采用旋股外侧动脉降支穿支皮瓣联合大隐静脉修复腕部创面并重建尺桡动脉。2例患者采用旋股外侧动脉降支穿支皮瓣修复腕部创面并重建尺动脉。切取的皮瓣大小为16 cm×12 cm至26 cm×16 cm，桥接血管长度为15至21 cm。5例患者的旋股外侧动脉降支穿支皮瓣均顺利成活。4例患者创面愈合，1例患者术后3天皮瓣下感染经换药及清创2周后创面愈合。术后5例患者腕手部血运良好，尺桡动脉恢复通畅。对患者随访6个月至1年，皮瓣外观良好，烧伤手部血运充足。旋股外侧动脉降支穿支皮瓣可修复腕部创面，恢复手部血运，是修复腕部高压电烧伤的良好方法。
