Cheng Lin, Dai Qiang, Du Wei-Li, Che Ke-Xin, Cao Tong-Yu, Shen Yu-Ming
From the Department of Burns and Plastic Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing, P.R. China.
Ann Plast Surg. 2025 Aug 1;95(2):151-155. doi: 10.1097/SAP.0000000000004370. Epub 2025 May 7.
The aim of this study was to investigate the clinical efficacy of a free double skin paddle anterolateral thigh (ALT) flap in treating 2 separate high-voltage electrical burn wounds affecting the wrist and hand.
A retrospective observational study was conducted, involving 25 patients who met the inclusion criteria between January 2019 and December 2023. The initial treatment protocol included an early emergency fasciotomy and vascular reconstruction. This was subsequently followed by wound repair employing a double skin ALT flap in the next stage of treatment.
Twenty-five double skin paddle ALT flaps were utilized for treating wrist and hand burn wounds in 25 male patients, aged 15-61 years. They comprised 21 cases of classic double skin paddle ALT flaps, 3 cases of artificial double skin paddle ALT flaps, and 1 case of a flow-through double skin paddle ALT flap. The dimensions of skin flaps ranged from 8 cm × 6 cm to 22 cm × 13 cm. Twenty-five ALT flaps were utilized, with 22 surviving completely. Complications included venous congestion (1 case), arterial thrombosis (1 case), and abscess (1 case), all managed surgically. The donor site was directly sutured and healed primarily in 19 cases, while a partial-thickness skin graft was used for closure in the remaining 6 cases. During a follow-up period ranging from 3 to 22 months, both the recipient and donor sites exhibited satisfactory healing, with no reported episodes of infection or abnormal discharge.
The utilization of a free double skin paddle ALT flap has led to satisfactory outcomes in treating 2 separate complex high-voltage electrical burn injuries to the wrist and hand. This technique achieves favorable reconstructive results, marked by minimal donor site morbidity, and it provides valuable insights into the management of similar cases.
本研究旨在探讨游离双叶股前外侧（ALT）皮瓣治疗累及腕部和手部的2处独立高压电烧伤创面的临床疗效。
进行一项回顾性观察研究，纳入2019年1月至2023年12月期间符合纳入标准的25例患者。初始治疗方案包括早期急诊筋膜切开减压和血管重建。随后在治疗的下一阶段采用双叶ALT皮瓣进行创面修复。
25例男性患者（年龄15 - 61岁）的腕部和手部烧伤创面采用了25个双叶ALT皮瓣进行治疗。其中经典双叶ALT皮瓣21例，人工双叶ALT皮瓣3例，穿流式双叶ALT皮瓣1例。皮瓣面积为8 cm×6 cm至22 cm×13 cm。共使用25个ALT皮瓣，22个完全存活。并发症包括静脉淤血（1例）、动脉血栓形成（1例）和脓肿（1例），均通过手术处理。供区19例直接缝合后一期愈合，其余6例采用中厚皮片移植封闭。在3至22个月的随访期内，受区和供区愈合均满意，未报告感染或异常分泌物情况。
游离双叶ALT皮瓣治疗累及腕部和手部的2处独立复杂高压电烧伤取得了满意效果。该技术获得了良好的重建效果，供区并发症少，为类似病例的处理提供了有价值的经验。
