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

Zhong Haiyan; Chen Yong; Du Xuanyu; Wang Qian; Wang Min; Zou Mingli; Yuan Siming

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

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.

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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

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

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Corresponding author: Yuan Siming, Email: yuansm@163.com
Received Date: 2023-06-13

Abstract

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.
- Burns, electric,
- Foot,
- Ankle,
- Pedicled axial flap,
- Skin and soft tissue defect,
- Wound repair

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References

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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

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

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