Effects of flow-through descending branch of lateral circumflex femoral artery flap on repairing high-voltage electrical burn wounds of wrist of patients
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摘要: 目的 探讨旋股外侧动脉降支血流桥接皮瓣治疗患者腕部高压电烧伤创面的效果。 方法 2014年1月—2016年6月,笔者单位收治5例单侧腕部高压电烧伤患者,烧伤腕部均有广泛的皮肤软组织坏死。患者均先于外院急诊行腕部皮肤切开减张术,于伤后6~12 d转入笔者单位。入院后2~3 d,于患者全身情况相对稳定下手术,手术分2组同时进行,一组行清创术,另一组根据腕部皮肤软组织缺损范围设计、切取皮瓣。清创后腕部创面面积为15 cm×10 cm~24 cm×15 cm。3例患者采用旋股外侧动脉降支血流桥接皮瓣并移植大隐静脉,修复腕部创面并重建尺、桡动脉;2例患者采用单纯旋股外侧动脉降支血流桥接皮瓣修复腕部创面并重建尺动脉。本组患者皮瓣切取面积为16 cm×12 cm~26 cm×16 cm,桥接血管长度为15~21 cm。 结果 本组5例患者旋股外侧动脉降支血流桥接皮瓣存活良好,4例患者创面修复,1例患者术后3 d皮瓣下感染,经换药、扩创后2周愈合。本组5例患者术后腕、手部血运良好,尺、桡动脉通畅。随访6个月~1年,皮瓣外形良好,患手血运好。 结论 旋股外侧动脉降支血流桥接皮瓣既能修复腕部创面,又能恢复手部血运,是修复腕部高压电烧伤创面的一种较为理想的方法。Abstract: Objective To investigate the effects of flow-through descending branch of lateral circumflex femoral artery flap on repairing high-voltage electrical burn wounds of wrist of patients. Methods From January 2014 to June 2016, 5 patients with high-voltage electrical burn of unilateral wrist were hospitalized in our burn ward, with extensive necrosis of skin soft tissue of burn wrist. Five patients were transferred to our burn ward 6 to 12 days post injury after undergoing emergency dermotomy of wrist to reduce tension in other hospitals. In 2 to 3 days after admission, operation was performed by two surgeon group at the same time, when patients′ general condition were stable. One group underwent debridement and the other group designed and dissected flap according to the range of skin soft tissue defect of wrist. Wrist wounds after debridement ranged from 15 cm×10 cm to 24 cm×15 cm. Three patients were treated with flow-through descending branch of lateral circumflex femoral artery flap and great saphenous vein for repairing wounds of wrist and reconstruction of ulnar and radial artery. Two patients were treated with flow-through descending branch of lateral circumflex femoral artery flap for repairing wounds of wrist and reconstruction of ulnar artery. The dissected flaps ranged from 16 cm×12 cm to 26 cm×16 cm and the length of bridging vessel ranged from 15 to 21 cm. Results The flow-through descending branch of lateral circumflex femoral artery flaps of five patients survived well. Wounds of 4 patients healed and wounds of 1 patient with infection under the flap on 3 days after operation healed after changing wound dressing and undergoing debridement for 2 weeks. After the operation, wrists and hands of 5 patients had adequate blood supply and ulnar and radial artery recovered patency. Follow-up of patients for 6 months to 1 year showed good flap appearance and adequate blood supply of burn hands. Conclusions The flow-through descending branch of lateral circumflex femoral artery flap can repair wrist wounds and recover blood supply of hands and it is a good method for repairing high-voltage electrical burns of wrist.
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Key words:
- Burns, electric /
- Surgical flaps /
- Wrist
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