Department of Orthopedics and Trauma, The Affiliated Zhengzhou Central Hospital of Zhengzhou University, Zhengzhou, 450000, China.
Department of Orthopedic and Trauma, Peking University People's Hospital, Beijing, 100044, China.
Eur J Trauma Emerg Surg. 2022 Apr;48(2):1381-1387. doi: 10.1007/s00068-021-01700-5. Epub 2021 May 31.
The purpose of this work was to validate the efficacy and safety of free medial plantar flap in repair of hand wounds resulted from high-voltage electrical burn.
22 patients with high-voltage electrical burn wounds were retrieved between July 2016 and July 2018 in the Affiliated Zhengzhou Central Hospital of Zhengzhou University. All the wounds were the entrance of high-voltage electrical current. After thorough debridement, the blood vessels, nerves, tendons, joints were exposed to defects with different degrees. The soft tissue defects were repaired with the free medial plantar flap repair in 12 patients and medium-thickness skin graft in 10 patients. Postoperative management was similar between the two groups.
All the operations were completed within 6 h. In the free medial plantar flap group, the mean follow-up period was (11.3 ± 2.4) months, ranging from 9 to 15 months, and all flaps survived; there were no vessel crises. Flaps of 10 patients healed without any complications, and local necrosis occurred in two cases, with healing after debridement. The two-point discrimination (TPD) was 7.0-11.0 mm, and the mean DASH score was 45.6 ± 7.4. In the medium-thickness skin graft group, the mean follow-up period was (10.9 ± 1.8) months. All flaps survived, and local contracture occurred in 3 cases. The TPD was 8.0-11.0 mm, and the mean DASH score was 60.7 ± 9.3.
The free medial plantar flap is an ideal option for repairing the hand soft defects resulted from the high-voltage electrical burn.
本研究旨在验证游离足底内侧皮瓣修复高压电烧伤手部创面的疗效和安全性。
回顾性分析 2016 年 7 月至 2018 年 7 月郑州大学附属郑州中心医院收治的 22 例高压电烧伤手部创面患者的临床资料。所有创面均为电流入口，彻底清创后，血管、神经、肌腱、关节不同程度外露，采用游离足底内侧皮瓣修复 12 例，中厚皮片移植修复 10 例。两组术后处理相似。
游离足底内侧皮瓣组手术均在伤后 6 h 内完成，平均随访时间（11.3±2.4）个月，915 个月，皮瓣均全部成活，无血管危象发生。10 例皮瓣愈合良好，无并发症，2 例局部皮瓣坏死，经清创后愈合；两点辨别觉（2-point discrimination，TPD）为 7.011.0 mm，DASH 评分平均为 45.6±7.4。中厚皮片移植组平均随访时间（10.9±1.8）个月，皮瓣全部成活，3 例出现局部挛缩，TPD 为 8.0~11.0 mm，DASH 评分平均为 60.7±9.3。
游离足底内侧皮瓣是修复高压电烧伤手部创面的理想选择。
