Abstract:
Objective To investigate the effects of flap or myocutaneous flap combined with fascia lata or composite mesh on repairing wounds in abdomen of patients with severe high-voltage electrical burn.
Methods From January 2010 to May 2017, 11 patients with severe high-voltage electrical burn in abdomen were hospitalized in our burn wards. In 3 hours to 7 days after burn, operation was performed when patients were in stable condition. After debridement, intestines with necrosis or perforation in 4 patients with peritoneal defects were resected and intestinal anastomosis was performed. The size of abdominal wounds after debridement ranged from 13 cm×9 cm to 41 cm×32 cm. Five patients were treated with rectus abdominis myocutaneous flap and size of which ranged from 14 cm×10 cm to 30 cm×17 cm. Among the above 5 patients, 4 patients with peritoneal defects used composite mesh of 25 cm×20 cm to enhance abdominal wall. Three patients were treated with tensor fascia lata myocutaneous flap, and size of the flap ranged from 24 cm×10 cm to 27 cm×13 cm. Three patients were treated with anterolateral thigh flap with fascia lata, and one of them was treated with the lobulated flap; size of the flap ranged from 18 cm×13 cm to 25 cm×15 cm. The later 6 patients used fascia lata of flap to enhance abdominal wall. The donor sites were sutured directly or repaired with intermediate split-thickness skin graft of thigh.
Results After operation, flaps or myocutaneous flaps of patients were survived, and strength of abdominal wall recovered. During follow-up of 6 month to 1 year, flaps or myocutaneous flaps were in good appearance, with no ankylenteron or abdominal wall hernia.
Conclusions Flap or myocutaneous flap combined with fascia lata or composite mesh can achieve good effects on repairing severe high-voltage electrical burn wounds in abdomen.