Meng Y B, Zhang H R, Wei J W, Zhang Y J, Li H S, Huo W L, Bai P Y
Institute of Burns, General Hospital of TISCO (the Sixth Hospital of Shanxi Medical University), Taiyuan 030009, China.
Department of Orthopedics, the Second Xiangya Hospital of Central South University, Changsha 410011, China.
Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi. 2023 Oct 20;39(10):953-958. doi: 10.3760/cma.j.cn501225-20230421-00138.
To explore the effects of low position lateral supramalleolar flap carrying periosteum and proximal leg propeller flap in relay repair of electric burn wounds of forefoot. A retrospective observational study was conducted. From January 2019 to January 2022, 12 patients with electric burn wounds of forefoot meeting the inclusion criteria were admitted to the Sixth Hospital of Shanxi Medical University, including 10 males and 2 females, aged 23-65 years. After debridement, the wound with an area of 6.0 cm×3.0 cm to 15.0 cm×7.0 cm was repaired with the lateral supramalleolar flap carrying part of the periosteum of the distal tibia and fibula with the rotation point moved down to the front of the ankle joint. The area of the cutted flap was 6.5 cm×3.5 cm-15.5 cm×7.5 cm. At the same stage, the donor site wound of lateral supramalleolar flap was repaired with peroneal artery or superficial peroneal artery perforator propeller flap in relay, with the relay flap area of 3.0 cm×1.5 cm-15.0 cm×4.0 cm. After operation, the survival of the lateral supramalleolar flap and relay flap, and the wound healing of the relay flap donor site were observed. During follow-up, the shapes of the lateral supramalleolar flap and its donor site were observed. After operation, one patient developed secondary blisters in the superficial skin distal to the lateral supramalleolar flap, which healed after dressing change, and the lateral supramalleolar flap and relay flaps survived well in the other patients; the donor site wound of the relay flap healed well. During follow-up of 12-18 months, the lateral supramalleolar flaps were in good shape and not bloated, with only linear scar left in the donor site of the flap. The low position lateral supramalleolar flap carrying periosteum can repair electric burn wounds of forefoot with advantages including reliable blood supply, low rotation point, and better repair effects. The use of relay flap to repair the donor site of lateral supramalleolar flap can reduce the damage to the appearance and function of the donor site.
探讨带骨膜的低位外踝上外侧皮瓣及小腿近端推进皮瓣接力修复前足电烧伤创面的效果。进行回顾性观察研究。2019年1月至2022年1月，山西医科大学第六医院收治符合纳入标准的前足电烧伤患者12例，其中男10例，女2例，年龄23 - 65岁。清创后，面积为6.0 cm×3.0 cm至15.0 cm×7.0 cm的创面采用携带胫腓骨远端部分骨膜的外踝上外侧皮瓣修复，旋转点下移至踝关节前方。切取皮瓣面积为6.5 cm×3.5 cm - 15.5 cm×7.5 cm。同期，外踝上外侧皮瓣供区创面采用腓动脉或腓浅动脉穿支推进皮瓣接力修复，接力皮瓣面积为3.0 cm×1.5 cm - 15.0 cm×4.0 cm。术后观察外踝上外侧皮瓣及接力皮瓣存活情况，以及接力皮瓣供区创面愈合情况。随访期间，观察外踝上外侧皮瓣及其供区外形。术后1例患者外踝上外侧皮瓣远端浅层皮肤出现继发性水疱，换药后愈合，其余患者外踝上外侧皮瓣及接力皮瓣存活良好；接力皮瓣供区创面愈合良好。随访12 - 18个月，外踝上外侧皮瓣外形良好，无臃肿，皮瓣供区仅留线状瘢痕。带骨膜的低位外踝上外侧皮瓣可修复前足电烧伤创面，具有血供可靠、旋转点低、修复效果较好等优点。采用接力皮瓣修复外踝上外侧皮瓣供区可减少对供区外观及功能的损伤。
