Email Alerts
RSS
Volume 39 Issue 6
Jun.  2023
Turn off MathJax
Article Contents
Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  > 2023  >  39(6): 527-533
Du WL,Shen YM,Hu XH,et al.Clinical effect of the giant deep inferior epigastric artery paraumbilical perforator flap in repairing the circular high-voltage electric burn wounds on the wrist[J].Chin J Burns Wounds,2023,39(6):527-533.DOI: 10.3760/cma.j.cn501225-20220719-00296.
Citation: Du WL,Shen YM,Hu XH,et al.Clinical effect of the giant deep inferior epigastric artery paraumbilical perforator flap in repairing the circular high-voltage electric burn wounds on the wrist[J].Chin J Burns Wounds,2023,39(6):527-533.DOI: 10.3760/cma.j.cn501225-20220719-00296.
shu

Clinical effect of the giant deep inferior epigastric artery paraumbilical perforator flap in repairing the circular high-voltage electric burn wounds on the wrist

doi: 10.3760/cma.j.cn501225-20220719-00296

  • Department of Burns, Beijing Jishuitan Hospital, Beijing 100035, China

Funds:

National Key Research and Development Program of China 2018YFA0703104

Capital Health Development Research Project 2020-2-1123

Discipline Backbone of Beijing Jishuitan Hospital XKGG202209

More Information
    Abstract
  •   Objective   To investigate the clinical effect of the giant deep inferior epigastric artery paraumbilical perforator flap in repairing the circular high-voltage electric burn wounds on the wrist.   Methods   A retrospective observational study method was used. From September 2016 to October 2021, thirteen male patients (aged 20-43 years) with annular high voltage (10-100 kV) electrical burns on the wrist were admitted to the Beijing Jishuitan Hospital. At the early stage after injury, the patient's wrist was subjected to incision, tension reduction and debridement, with the wound area after debridement being 27 cm×16 cm-32 cm×19 cm; in 12 patients with vascular injury, the radial or ulnar artery was reconstructed by great saphenous vein transplantation, with the length of 15-25 cm; the wrist wound was repaired by free transplantation of the deep inferior epigastric artery paraumbilical perforator flap (if the wound was giant, the lower abdominal flap carrying other perforators was used), with the area of 30 cm×19 cm-35 cm×20 cm. The donor site was repaired by direct suture+skin grafting or relay flap transplantation. After surgery, the survival of flap in recipient area, as well as survival of the skin or flap in donor site were observed. During follow-up, the appearances of the flap in recipient area and the recovery of hand function, as well as the healing of donor site, occurrence of abdominal wall hernia, and scar in skin graft area were observed.   Results   After surgery, all the 13 patients' paraumbilical perforator flaps survived. Among them, 3 patients had subcutaneous fat necrosis at the distal end of the wrist flap, and the wound had mild infection, which healed after re-expansion and dressing change. All the skin grafts in the donor site of 10 patients survived, and the flaps in the donor site of 3 patients survived well. The patients were followed up for 6 months to 3 years. The flaps in recipient area were in good shape, 8 cases had partial recovery of hand function, and 5 cases had loss of finger flexion function; the donor site of abdominal flap healed well with no abdominal hernia occurred, and the skin graft site had no obvious scar hyperplasia and was soft in texture.   Conclusions   Early vascular reconstruction after injury, together with free transplantation of the giant deep inferior epigastric artery paraumbilical perforator flap are effective in repairing circular high-voltage electrical burn wounds on the wrist.

     

    • FullText(HTML)
  • loading
    • References(31)
  • [1]
    沈余明, 马春旭, 覃凤均, 等. 腕部高压电烧伤创面修复与功能重建[J].中华烧伤杂志,2017,33(12):738-743.DOI: 10.3760/cma.j.issn.1009-2587.2017.12.004.
    [2]
    沈余明, 覃凤均, 杜伟力, 等. 濒临截肢四肢高压电烧伤患者的保肢策略[J].中华烧伤杂志,2019,35(11):776-783. DOI: 10.3760/cma.j.issn.1009-2587.2019.11.003.
    [3]
    HuXH, QinFJ, ChenZ, et al. Combined rectus abdominis muscle/paraumbilical flap and lower abdominal flap for the treatment of type Ⅲ circumferential electrical burns of the wrist[J]. Burns, 2013,39(8):1631-1638. DOI: 10.1016/j.burns.2013.04.014.
    [4]
    沈余明, 田彭, 宁方刚, 等. 腹部联合轴型皮瓣修复腕部环状高压电烧伤创面[J].中华烧伤杂志,2012,28(6):408-410. DOI: 10.3760/cma.j.issn.1009-2587.2012.06.003.
    [5]
    OferN, BaumeisterS, MegerleK, et al. Current concepts of microvascular reconstruction for limb salvage in electrical burn injuries[J]. J Plast Reconstr Aesthet Surg, 2007,60(7):724-730. DOI: 10.1016/j.bjps.2006.12.010.
    [6]
    GencelE, EserC, KesiktasE, et al. A cross flow-through pedicle free latissimus dorsi flap for high voltage electrical burns[J]. Burns, 2016,42(4):e55-60. DOI: 10.1016/j.burns.2015.10.014.
    [7]
    唐林, 周鑫, 黄宇, 等. 组合股前外侧穿支皮瓣与不同皮瓣瓦合修复肢体大面积环形缺损[J].中国修复重建外科杂志,2021,35(12):1609-1614. DOI: 10.7507/1002-1892.202108002.
    [8]
    NgZY, TanSS, LellouchAG, et al. Soft tissue reconstruction of complete circumferential defects of the upper extremity[J]. Arch Plast Surg, 2017,44(2):117-123. DOI: 10.5999/aps.2017.44.2.117.
    [9]
    CiudadP, HuangTC, ManriqueOJ, et al. Expanding the applications of the combined transverse upper gracilis and profunda artery perforator (TUGPAP) flap for extensive defects[J]. Microsurgery, 2019,39(4):316-325. DOI: 10.1002/micr.30413.
    [10]
    OuQ, WuP, ZhouZ, et al. Algorithm for covering circumferential wound on limbs with ALTP or/and DIEP flaps based on chain-linked design and combined transplantation[J]. Injury, 2021,52(6):1356-1362. DOI: 10.1016/j.injury.2020.10.031.
    [11]
    OuQ, WuP, PanD, et al. Combined transfer by several perforator skin flaps to cover an extensive and multiplanar wound on the foot and ankle[J]. J Plast Reconstr Aesthet Surg, 2022,75(10):3751-3760. DOI: 10.1016/j.bjps.2022.06.081.
    [12]
    QingL, LiX, WuP, et al. Customized reconstruction of complex soft-tissue defect in the hand and forearm with individual design of chain-linked bilateral anterolateral thigh perforator flaps[J]. J Plast Reconstr Aesthet Surg, 2019,72(12):1909-1916. DOI: 10.1016/j.bjps.2019.08.004.
    [13]
    周鑫, 宋达疆, 邹永根. 游离胸背动脉穿支皮瓣联合旋髂浅动脉穿支皮瓣移植修复下肢大面积环周软组织缺损一例[J].中国修复重建外科杂志,2021,35(3):399-400. DOI: 10.7507/1002-1892.202010007.
    [14]
    周征兵, 唐举玉, 吴攀峰, 等. 双侧旋股外侧动脉降支穿支皮瓣组合移植修复下肢大面积软组织缺损[J].中华显微外科杂志,2020,43(6):535-539. DOI: 10.3760/cma.j.cn441206-20200314-00150.
    [15]
    刘安铭, 周鑫, 欧昌良, 等. 携带双侧旋髂浅动脉的腹部游离皮瓣修复足踝部大面积皮肤软组织缺损[J].中国修复重建外科杂志,2021,35(7):886-890. DOI: 10.7507/1002-1892.202103023.
    [16]
    沈余明, 胡骁骅, 宓惠茹, 等. 四肢高压电烧伤创面的早期处理[J].中华烧伤杂志,2011,27(3):173-177. DOI: 10.3760/cma.j.issn.1009-2587.2011.03.003.
    [17]
    沈余明, 陈旭, 张琮, 等. 旋股外侧动脉降支血流桥接皮瓣修复患者腕部高压电烧伤创面的效果[J].中华烧伤杂志,2017,33(7):422-425. DOI: 10.3760/cma.j.issn.1009-2587.2017.07.006.
    [18]
    WangC, ShenYM, QinFJ, et al. Free flow-through anterolateral thigh flaps for wrist high-tension electrical burns: a retrospective case series[J]. Biomed Environ Sci, 2020,33(7):510-517. DOI: 10.3967/bes2020.064.
    [19]
    李利根, 柴家科. 肢体高压电烧伤软组织及血管损伤的影像学判断及临床意义[J].中华烧伤杂志,2020,36(11):1009-1012. DOI: 10.3760/cma.j.cn501120-20190904-00371.
    [20]
    黎淑娟, 王正磊, 朱维平, 等. 四肢高压电烧伤早期磁共振成像特点的临床研究[J].中华烧伤杂志,2017,33(12):750-756. DOI: 10.3760/cma.j.issn.1009-2587.2017.12.006.
    [21]
    NettelbladH, ThuomasKA, SjöbergF. Magnetic resonance imaging: a new diagnostic aid in the care of high-voltage electrical burns[J]. Burns, 1996,22(2):117-119. DOI: 10.1016/0305-4179(95)00104-2.
    [22]
    刘灿丽, 孙勇, 顾亚律, 等. 多层螺旋CT高压电损伤肢体灌注成像临床应用[J].中国临床医学影像杂志,2012,23(2):100-102. DOI: 10.3969/j.issn.1008-1062.2012.02.008.
    [23]
    徐勇辉, 孙勇, 刘灿丽, 等. 256层螺旋CT灌注成像对高压电击伤截肢适应证判断的初步应用[J].影像诊断与介入放射学,2015,24(1):59-63. DOI: 10.3969/j.issn.1005-8001.2015.01.011.
    [24]
    吴有森, 鲍海华, 孙艳秋, 等. CT血管成像在四肢高压电击伤中的应用[J].实用放射学杂志,2012,28(10):1595-1598. DOI: 10.3969/j.issn.1002-1671.2012.10.028.
    [25]
    杨智斌, 牛建栋, 马勇, 等. CT血管造影及三维重建在组织瓣修复颈肩、腋窝及上臂高压电烧伤创面中的临床应用[J].中华烧伤杂志,2018,34(12):874-880. DOI: 10.3760/cma.j.issn.1009-2587.2018.12.011.
    [26]
    沈余明. 高压电烧伤创面修复与功能重建[J].中华烧伤杂志,2018,34(5):257-262. DOI: 10.3760/cma.j.issn.1009-2587.2018.05.001.
    [27]
    文一臻, 张丕红, 任利成, 等. 136例上肢电烧伤患者的临床特征及修复效果[J].中华烧伤杂志,2019,35(11):784-789. DOI: 10.3760/cma.j.issn.1009-2587.2019.11.004.
    [28]
    AyazM. High voltage electrical injury, early vs. late wound excision, and coverage[J]. Burns, 2020,46(6):1476-1477. DOI: 10.1016/j.burns.2020.04.043.
    [29]
    DeBonoR. A histological analysis of a high voltage electric current injury to an upper limb[J]. Burns, 1999,25(6):541-547. DOI: 10.1016/s0305-4179(99)00029-7.
    [30]
    KalkanT, DemirM, AhmedAS, et al. A dynamic study of the thermal components in electrical injury mechanism for better understanding and management of electric trauma: an animal model[J]. Burns, 2004,30(4):334-340. DOI: 10.1016/j.burns.2003.11.009.
    [31]
    ZeltRG, DanielRK, BallardPA, et al. High-voltage electrical injury: chronic wound evolution[J]. Plast Reconstr Surg, 1988, 82(6): 1027-1041. DOI: 10.1097/00006534-198812000-00014.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(3)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (1089) PDF downloads(85) Cited by()
    Proportional views
    Related

    Copyright © Chinese Journal of Burns京ICP备07035254号-14

    E-mail：shaoshangzazhi@163.com

    Website：https://zhsszz.xml-journal.net/

    Supported by: Beijing Renhe Information Technology Co. Ltd    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return