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Volume 39 Issue 10
Oct.  2023
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Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  > 2023  >  39(10): 939-946
Zhong HY,Chen Y,Du XY,et al.Selection strategy of pedicled axial flaps for repairing high-voltage electric burn wounds in foot and ankle[J].Chin J Burns Wounds,2023,39(10):939-946.DOI: 10.3760/cma.j.cn501225-20230613-00212.
Citation: Zhong HY,Chen Y,Du XY,et al.Selection strategy of pedicled axial flaps for repairing high-voltage electric burn wounds in foot and ankle[J].Chin J Burns Wounds,2023,39(10):939-946.DOI: 10.3760/cma.j.cn501225-20230613-00212.
shu

Selection strategy of pedicled axial flaps for repairing high-voltage electric burn wounds in foot and ankle

doi: 10.3760/cma.j.cn501225-20230613-00212

  • Department of Burn and Plastic Surgery, General Hospital of Eastern Theater Command, Nanjing 210002, China

Funds:

The 333 Project Scientific Research Program of Jiangsu Province of China BRA2020416

More Information
  • Corresponding author: Yuan Siming, Email: yuansm@163.com
  • Received Date: 2023-06-13
    Abstract
  •   Objective   To explore the selection strategy of pedicled axial flaps for repairing high-voltage electric burn wounds in foot and ankle.   Methods   The retrospective observational research method was used. From January 2017 to December 2022, 16 patients with skin and soft tissue defects in foot and ankle after high-voltage electric burns were treated in General Hospital of Eastern Theater Command, including 11 cases of unilateral defect and 5 cases of bilateral defect. All patients were male, aged from 25 to 75 years. After thorough debridement, the area of the defect to be repaired with the flap was 5.0 cm×4.0 cm to 12.0 cm×8.0 cm. Before operation, the color Doppler ultrasound, computed tomography angiography, or digital subtraction angiography was used to fully evaluate the degree of vascular injury in the affected limb and to identify the distribution and traffic anastomosis of vascular network. Pedicled axial flaps with reliable blood supply were used to repair the wounds as soon as possible, and the area of flaps ranged from 3.0 cm×2.0 cm to 13.0 cm×8.0 cm. The wound in the donor area of flaps was repaired with split-thickness skin graft from head or medium-thickness skin graft from thigh. The flap repair of wounds in various areas of the ankle and foot was recorded. The postoperative survivals of the flaps and skin grafts were observed after surgery. The postoperative appearance of flaps and walking function of patients were followed up. At the last follow-up, the foot and ankle function was evaluated and rated using the American Association of Foot and Ankle Surgeons Ankle Posterior Foot Scoring System.   Results   Two wounds in toe area were repaired with reverse dorsal pedis flaps, 3 wounds in medial ankle area and 2 wounds in heel area were repaired with medial plantar flaps, 2 wounds in anterior plantar area combined with toe area were repaired with reverse medial plantar flaps, 2 wounds in anterior plantar area combined with toe area and 5 wounds in anterior plantar area were repaired with reverse medial pedis flaps, 1 wound in toe area was combined with proper plantar digital artery flap, 1 dorsal pedis wound and 1 lateral malleolus wound were repaired with lateral supramalleolar perforator flaps, and 1 lateral malleolus wound and 1 dorsal pedis wound were repaired with sural neurovascular flap. One flap had venous reflux disorder after surgery and survived after treatment, while the other flaps and skin grafts survived completely after surgery. During the follow-up of 6 to 24 months after operation, the appearance of the flaps was good, and the walking function of patients was normal. At the last follow-up, the functional score of foot and ankle was 76 to 95, which was evaluated as excellent in 11 cases and good in 5 cases.   Conclusions   According to the condition of high-voltage electric burn in foot and ankle, early and thorough debridement, preoperative imaging examination to evaluate blood vessels of the affected limb, and selection of pedicled axial flap with reliable blood supply are good methods for wound repair and related functional reconstruction of high-voltage electric burn in foot and ankle.

     

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    • References(25)
  • [1]
    魏伟,张庆富.电烧伤和热力烧伤皮肤的组织学观察[J].中华烧伤杂志,2020,36(6):425.DOI: 10.3760/cma.j.issn.1009-2587.2020.06.102.
    [2]
    杜伟力,沈余明,胡骁骅,等.巨大腹壁下动脉脐旁穿支皮瓣修复腕部环状高压电烧伤创面的临床效果[J].中华烧伤与创面修复杂志,2023,39(6):527-533.DOI: 10.3760/cma.j.cn501225-20220719-00296.
    [3]
    贾伟,刘建龙,覃凤均,等. 高压电烧伤合并肢体血管损伤治疗10年回顾性分析[J]. 中国普通外科杂志,2022,31(6):760-766. DOI: 10.7659/j.issn.1005-6947.2022.06.008.
    [4]
    狄海萍,李永林,邢培朋,等.皮瓣修复腕部高压电烧伤创面的手术时机选择[J].中华显微外科杂志,2019,42(2):166-169.DOI: 10.3760/cma.j.issn.1001-2036.2019.02.016.
    [5]
    AggarwalS,MaitzP,KennedyP.Electrical flash burns due to switchboard explosions in New South Wales--a 9-year experience[J].Burns,2011,37(6):1038-1043.DOI: 10.1016/j.burns.2011.01.017.
    [6]
    刘军,刘建云,余小平. 足踝部高压电烧伤的手术治疗[J]. 临床医学,2020,40(10):10-12. DOI: 10.19528/j.issn.1003-3548.2020.010.004.
    [7]
    KohD,LimJ,ChenJY,et al.Flexor hallucis longus transfer versus turndown flaps augmented with flexor hallucis longus transfer in the repair of chronic Achilles tendon rupture[J].Foot Ankle Surg,2019,25(2):221-225.DOI: 10.1016/j.fas.2017.10.019.
    [8]
    QianW,WangS,WangY,et al.Epidemiological and clinical characteristics of burns in the older person: a seven-year retrospective analysis of 693 cases at a burn center in south-west China[J/OL].Burns Trauma,2020,8:tkz005[2023-06-13].https://pubmed.ncbi.nlm.nih.gov/32346542/.DOI: 10.1093/burnst/tkz005.
    [9]
    张丕红. 加强规范化诊治　改善电烧伤预后 [J] . 中华烧伤杂志,2019,35 (11): 772-775. DOI: 10.3760/cma.j.issn.1009-2587.2019.11.002.
    [10]
    赵黎君,周琴,邹小梅. 鼠神经生长因子联合腹部超薄皮瓣修复手部深度电烧伤创面[J]. 中国美容医学,2022,31(10):31-34. DOI: 10.15909/j.cnki.cn61-1347/r.005286.
    [11]
    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.
    [12]
    朱志祥,王松柏.足解剖分区和修复方法[J].实用美容整形外科杂志,1997(3):46-48.
    [13]
    亢向辉,赵建强,孙杰,等.Flow-through足背皮瓣在拇指撕脱离断伤再植术中的应用[J].中华手外科杂志,2022,38(2):157-158.DOI: 10.3760/cma.j.cn311653-20210511-00159.
    [14]
    王晓东,魏杰,曹鑫杰,等.腓肠神经营养血管皮瓣修复跟腱周围软组织缺损的临床疗效[J].中华显微外科杂志,2020,43(1):81-85.DOI: 10.3760/cma.j.issn.1001-2036.2020.01.022.
    [15]
    KarimiH,AkhoondinasabMR,Kazem-ZadehJ,et al.Comparison of the results of early flap coverage with late flap coverage in high-voltage electrical injury[J].J Burn Care Res,2017,38(2):e568-e573.DOI: 10.1097/BCR.0000000000000422.
    [16]
    SauerbierM,OferN,GermannG,et al.Microvascular reconstruction in burn and electrical burn injuries of the severely traumatized upper extremity[J].Plast Reconstr Surg,2007,119(2):605-615.DOI: 10.1097/01.prs.0000246512.47204.da.
    [17]
    JanisJE,KhansaI,LehrmanCR,et al.Reconstructive management of devastating electrical injuries to the face[J].Plast Reconstr Surg,2015,136(4):839-847.DOI: 10.1097/PRS.0000000000001619.
    [18]
    ZeidermanMR,PuLLQ.Contemporary approach to soft-tissue reconstruction of the lower extremity after trauma[J/OL].Burns Trauma,2021,9:tkab024[2023-06-13].https://pubmed.ncbi.nlm.nih.gov/34345630/.DOI: 10.1093/burnst/tkab024.
    [19]
    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.
    [20]
    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.
    [21]
    夏成德,狄海萍,邢培朋,等.游离股薄肌肌瓣联合腓肠神经移植重建腕部电烧伤患者手屈指和感觉功能的效果[J].中华烧伤与创面修复杂志,2023,39(3):228-233.DOI: 10.3760/cma.j.cn501225-20221203-00525.
    [22]
    CastroJC, ColtroPS, MillanLS, et al. Early application of microsurgical flaps in the electric burns of extremities: a two institutional case series[J]. J Burn Care Res, 2018,39(6):1037-1042. DOI: 10.1093/jbcr/irx010.
    [23]
    赵学刚,张庆富.电烧伤截肢的预测因子和重建管理[J].中华烧伤与创面修复杂志,2023,39(8):730.DOI: 10.3760/cma.j.issn.2097-1109.2023.08.101.
    [24]
    仓正强,倪小冬,王慜,等.足底内侧皮瓣在踝周软组织缺损修复中的应用[J].组织工程与重建外科杂志,2019,15(1):29-31.DOI: 10.3969/j.issn.1673-0364.2019.01.008.
    [25]
    徐强,张锡平,王镖,等.远端蒂腓肠神经营养血管皮瓣的解剖及临床应用[J].实用骨科杂志,2020,26(3):228-231.
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