d'Amato T A, Kaplan I B, Britt L D
Department of General Surgery, Eastern Virginia Graduate School of Medicine, Norfolk 23507.
J Natl Med Assoc. 1994 Jul;86(7):535-7.
Patients sustaining high-voltage electrical burns involving the upper extremities were evaluated for deep muscle compartment necrosis by early surgical exploration. Following resuscitation, patients were taken to the operating room where mandatory exploration of volar and extensor forearm and hand compartments was done to evaluate muscle viability. It was observed that deep muscle layers sustained the greatest thermal injury and that extended fasciotomies were required to obviate compartment syndrome and the potential for continued ischemia. Although 10 emergency amputations were required for six patients, those who underwent extensive exploration of their forearms and hands did not require subsequent amputation for nonviable extremities during second-look operations. These observations support the role for early exploration with generous exposure of deep muscle compartments to access and treat the thermal injury that results from high-voltage burns.
对上肢遭受高压电烧伤的患者，通过早期手术探查评估深部肌肉间隔坏死情况。复苏后，患者被送往手术室，对掌侧和背侧前臂及手部间隔进行强制性探查，以评估肌肉活力。观察发现，深部肌肉层遭受的热损伤最为严重，需要进行广泛的筋膜切开术以避免间隔综合征和持续缺血的可能性。虽然6名患者中有10例需要急诊截肢，但那些接受了前臂和手部广泛探查的患者在二次手术时并未因肢体无活力而需要再次截肢。这些观察结果支持早期探查的作用，即充分暴露深部肌肉间隔，以接近并治疗高压烧伤导致的热损伤。
