A case of repairing the destructive high-voltage electric burn wounds in the head, face, and neck based on the economic theory of flaps
-
摘要:
2021年9月8日，太原钢铁（集团）有限公司总医院收治1例18岁男性高压电烧伤导致头面颈部严重毁损伤患者。基于皮瓣经济学理论，术前针对皮瓣供区、移植方式进行优化评价后，行头面颈部创面清创+坏死颅骨去除+超大背阔肌肌皮瓣游离移植+左大腿薄中厚皮片移植术，并将超大的供瓣区创面直接缝合。该术式在保证修复效果前提下，最大限度地减轻了供区的不良后果。术后患者病情平稳，皮瓣及皮片存活良好，创面修复效果良好，供瓣区瘢痕轻微，上肢无功能障碍。 Abstract: In September 8 th, 2021, a male patient (aged 18 years) with severe destructive injuries of high-voltage electric burns in the head, face, and neck was admitted to General Hospital of Taiyuan Iron Steel (Group) Co., Ltd. Based on the economic theory of flaps, the flap donor site and transplantation method were optimized and evaluated before surgery, and then debridement of head, face, and neck wounds+removal of necrotic skull+free transplantation of super large latissimus dorsi myocutaneous flap+thin intermediate thickness skin graft transplantation from the left thigh was performed. The extra large flap donor site wound was sutured directly. This surgery reduced the adverse consequences of the flap donor site on the premise of ensure of repair effect. After operation, the patient's condition was stable, the flap and skin graft survived well, the repair effect of wound was well, the scar in the flap donor area was relatively mild, and the upper limb had no dysfunction.-
Key words:
- Burns, electric /
- Surgical flaps /
- Myocutaneous flap /
- Economics of flaps /
- Wound repair
-
参考文献
(14) [1] 侯宏义,郭凯,郑朝,等.早期采用游离皮瓣修复头面部严重毁损伤创面的临床研究[J].空军军医大学学报,2023,44(3):262-265.DOI: 10.13276/j.issn.2097-1656.2023.03.013. [2] 郑朝,胡大海,朱雄翔,等.头面颈部皮肤软组织缺损的显微外科修复[J].中华烧伤杂志,2010,26(4):263-267.DOI: 10.3760/cma.j.issn.1009-2587.2010.04.005. [3] 郭鹏飞,王旭,魏爱周,等.基于供区保护理念的游离股前外侧分叶穿支皮瓣在头部电烧伤创面修复中的临床应用效果[J].中华烧伤与创面修复杂志,2022,38(1):77-80.DOI: 10.3760/cma.j.cn501120-20201111-00470. [4] AithalK, JenaUK, VasireddyS, et al.Reconstruction of scalp defects in electrical burns: challenges and options[J]. J Head Neck Physicia, 2021,9(1):56-58.DOI: 10.4103/jhnps.jhnps_63_20. [5] 李罡,张志,李孝建,等.腹腔镜下切取大网膜游离移植修复大面积头皮缺损伴颅骨外露创面一例[DB/OL]. 中国临床案例成果数据库,2022(2022-01-19) [2023-11-01].http://journal.yiigle.com/LinkIn.do?linkin_type=cma&DOI=10.3760/cma.j.cmcr.2022.e00315. http://journal.yiigle.com/LinkIn.do?linkin_type=cma&DOI=10.3760/cma.j.cmcr.2022.e00315 [6] RoseEH.Aesthetic reconstruction of the severely disfigured burned face: a creative strategy for a "natural" appearance using pre-patterned autogenous free flaps[J/OL].Burns Trauma,2015,3:16[2023-11-01].https://pubmed.ncbi.nlm.nih.gov/27574662/.DOI: 10.1186/s41038-015-0014-8. [7] 李小静,宁金龙,高学宏,等.大面积头皮缺损及颅骨外露的显微外科修复[J].中华显微外科杂志,2004,27(1):30-31.DOI: 10.3760/cma.j.issn.1001-2036.2004.01.011. [8] 吴海涛,程磊,陶磊,等.游离皮瓣修复头颈部肿瘤术后组织缺损[J].中国眼耳鼻喉科杂志,2019,19(5):325-327,331.DOI: 10.14166/j.issn.1671-2420.2019.05.009. [9] 马超,陶然,舒军,等.背阔肌肌皮瓣修复较大软组织缺损的方法及供区继发创面的处理[J].中华烧伤杂志,2020,36(12):1199-1203.DOI: 10.3760/cma.j.cn501120-20191121-00439. [10] 刘晓春,黄东,牟勇,等.髂腹股沟接力皮瓣修复股前外侧皮瓣供区[J].实用手外科杂志,2022,36(2):145-147,206.DOI: 10.3969/j.issn.1671-2722.2022.02.003. [11] 刘毅.重视供区的美容修复[J].中华烧伤杂志,2020,36(2):81-84.DOI: 10.3760/cma.j.issn.1009-2587.2020.02.001. [12] 唐举玉,汪华侨,HallockGG,等.关注皮瓣供区问题—减少皮瓣供区损害专家共识[J].中华显微外科杂志,2018,41(1):3-5.DOI: 10.3760/cma.j.issn.1001-2036.2018.01.001. [13] 张茂红,杜庆安,李侃.肿瘤整形外科技术在头皮肿瘤手术中的应用[J].中国肿瘤外科杂志,2012,4(2):72-75.DOI: 10.3969/j.issn.1674-4136.2012.02.003. [14] ZeidermanMR, PuLLQ. Contemporary reconstruction after complex facial trauma[J/OL]. Burns Trauma, 2020, 8:tkaa003[2023-11-01]. https://pubmed.ncbi.nlm.nih.gov/32341916/. DOI: 10.1093/burnst/tkaa003. -
下载:
图(1)
计量
- 文章访问数: 134
- HTML全文浏览量: 33
- PDF下载量: 25
- 被引次数: 0
