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Volume 39 Issue 11
Nov.  2023
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Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  > 2023  >  39(11): 1030-1037
Xu JH,Zhang W,Zhou JX,et al.Clinical effects of free transplantation of inguinal flap in repairing electrical burn wounds of mice in the limbs[J].Chin J Burns Wounds,2023,39(11):1030-1037.DOI: 10.3760/cma.j.cn501225-20230804-00039.
Citation: Xu JH,Zhang W,Zhou JX,et al.Clinical effects of free transplantation of inguinal flap in repairing electrical burn wounds of mice in the limbs[J].Chin J Burns Wounds,2023,39(11):1030-1037.DOI: 10.3760/cma.j.cn501225-20230804-00039.
shu

Clinical effects of free transplantation of inguinal flap in repairing electrical burn wounds of mice in the limbs

doi: 10.3760/cma.j.cn501225-20230804-00039

  • Department of Burns, Tongren Hospital of Wuhan University ＆ Wuhan Third Hospital, Wuhan 430060, China

Funds:

Clinical Medical Research Project of Wuhan WX20Q18

Knowledge Innovation Program of Wuhan-Shugung Project 2022020801020553

More Information
  • Corresponding author: Zhang Wei, Email: zhw010@163.com
  • Received Date: 2023-08-04
    Abstract
  •   Objective   To investigate the clinical effects of free transplantation of inguinal flap in repairing electrical burn wounds of mice in the limbs.   Methods   A retrospective observational study was conducted. From January 2012 to May 2023, 24 male patients with electrical burns in the limbs meeting the inclusion criteria, aged 20 to 69 years, were admitted to the Department of Burns of Tongren Hospital of Wuhan University ＆ Wuhan Third Hospital. Totally 27 limbs were involved, including 18 upper limbs and 9 lower limbs. After debridement, the wound area in the limbs proposed to be repaired with the inguinal flap was 5.0 cm×1.5 cm-20.0 cm×9.0 cm. A total of 26 operations were performed in 24 patients, and 27 free inguinal flaps with area being 5.0 cm×3.5 cm-22.0 cm×12.0 cm were resected, including 6 for lobed transplantation, 2 for chimeric transplantation with iliac bone graft, 3 for conjoined transplantation with pedicled latissimus dorsi myocutaneous flap, and 1 for conjoined transplantation with free paraumbilical perforator flap. Indocyanine green angiography was used to evaluate the blood supply of the inguinal flap during operation, to guide arterial supercharge during transplantation. Among the transplanted inguinal flaps, 5 were pedicled with the common trunk of the superficial circumflex iliac artery and the superficial abdominal wall artery, 13 were pedicled with the superficial circumflex iliac artery alone, 6 were pedicled with the superficial abdominal wall artery alone, and the remaining 3 were simultaneously anastomosed with the superficial circumflex iliac artery and the superficial abdominal wall artery for arterial supercharge. In another patient, the deep branch of the superficial circumflex iliac artery was used as a bridging vessel to recanalize the proper artery of the index finger in the distal segment. The wound in the donor area were sutured directly. The blood supply status of the inguinal flap immediately after resection but before cutting off blood vessels and after transplantation and vascular anastomosis was recorded. The survival of the tissue flap, the fixation of the iliac bone graft, and the healing of secondary defect in the donor area were observed after surgery. The appearance of the inguinal flap and the functional recovery of the recipient area were followed up. At the last follow-up, the function of the affected upper limb was scored using the Arm, Shoulder, and Hand Disability (DASH) scoring scale, and the satisfaction of patients with the efficacy of each surgical treatment was investigated by referring to the 5-level Likert scale.   Results   Totally 27 inguinal flaps showed good arterial blood perfusion and venous return immediately after resection but before cutting off blood vessels and after transplantation and vascular anastomosis. Except for one inguinal flap that developed necrosis 12 days after operation and was repaired by split-thickness skin graft from the head, the remaining 26 inguinal flaps and conjointly transplanted tissue flaps survived completely without vascular crisis. The iliac bone graft was fixed securely after operation. All secondary defects in donor area healed well after operation. After 6 to 36 months of follow-up, the inguinal flap was soft in texture, without obvious swelling, the function of the recipient area was significantly improved as compared with that before surgery, and the protective feeling of the inguinal flap was restored. At the last follow-up, the functional scores of DASH scoring scale of the 18 affected upper limbs ranged from 0 to 100 (with a mean of 27). The patients were very satisfied with the efficacy of 17 surgical treatments and relatively satisfied with the efficacy of 9 surgical treatments.   Conclusions   The donor area of the inguinal flap is concealed, and the damage resulted from flap resection in this area is small. This flap has a rich blood supply. In the electrical burn wounds of mice in the limbs repaired with lobed transplantation, chimeric transplantation, and conjoined transplantation with other flaps, the appearance and function of the recipient area are well restored, and the patients' satisfaction with the efficacy of surgical treatment is high, which is worthy of clinical promotion.

     

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    • References(30)
  • [1]
    ZhaoJC,ShiK,HongL,et al.Retrospective review of free anterolateral thigh flaps for limb salvage in severely injured high-voltage electrical burn patients[J].Ann Plast Surg,2018,80(3):232-237.DOI: 10.1097/SAP.0000000000001283.
    [2]
    LeeDH,DesaiMJ,GaugerEM.Electrical injuries of the hand and upper extremity[J].J Am Acad Orthop Surg,2019,27(1):e1-e8.DOI: 10.5435/JAAOS-D-17-00833.
    [3]
    HussainT,KhanFH,RahmanOU,et al.Superficial circumflex iliac artery free flap for coverage of hand injuries[J].Cureus,2022,14(11):e31520.DOI: 10.7759/cureus.31520.
    [4]
    张伟,陈斓,杨飞,等.上肢毁损性电烧伤的救治方法及其临床疗效[J].中华烧伤与创面修复杂志,2023,39(8):731-737.DOI: 10.3760/cma.j.cn501225-20230530-00188.
    [5]
    PukancsikD,KelemenP,GulyásG,et al.Clinical experiences with the use of ULTRAPRO® mesh in single-stage direct-to-implant immediate postmastectomy breast reconstruction in 102 patients: a retrospective cohort study[J].Eur J Surg Oncol,2017,43(7):1244-1251.DOI: 10.1016/j.ejso.2017.01.236.
    [6]
    DingH,HuangM,LiD,et al.Epidemiology of electrical burns: a 10-year retrospective analysis of 376 cases at a burn centre in South China[J].J Int Med Res,2020,48(3):300060519891325.DOI: 10.1177/0300060519891325.
    [7]
    蒋梅君,李泽,谢卫国.2 133例电烧伤住院患者流行病学调查[J].中华烧伤杂志,2017,33(12):732-737.DOI: 10.3760/cma.j.issn.1009-2587.2017.12.003.
    [8]
    Al-BennaS.Electrical burns in adults[J].Acta Chir Plast,2023,65(2):66-69.DOI: 10.48095/ccachp202366.
    [9]
    YangJ,TianG,LiuJ,et al.Epidemiology and clinical characteristics of burns in mainland China from 2009 to 2018[J/OL].Burns Trauma,2022,10:tkac039[2023-08-04].https://pubmed.ncbi.nlm.nih.gov/36196302/.DOI: 10.1093/burnst/tkac039.
    [10]
    GrigorEJM,BitoiuB,ZeitouniC,et al.Patient-reported outcomes following free flap lower extremity reconstruction: a systematic review and meta-analysis[J].J Plast Reconstr Aesthet Surg,2023,76:251-267.DOI: 10.1016/j.bjps.2022.08.077.
    [11]
    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.
    [12]
    张丕红,张明华,谢庭鸿,等.游离上臂外侧穿支皮瓣修复手足部电烧伤创面[J].中华烧伤杂志,2013,29(5):424-426.DOI: 10.3760/cma.j.issn.1009-2587.2013.05.004.
    [13]
    张伟,谢卫国,杨飞,等.游离股前外侧穿支皮瓣分叶移植在四肢电烧伤治疗中的临床应用[J].中华烧伤杂志,2019,35(11):790-797.DOI: 10.3760/cma.j.issn.1009-2587.2019.11.005.
    [14]
    TiwariVK,SarabahiS,ChauhanS.Preputial flap as an adjunct to groin flap for the coverage of electrical burns in the hand[J].Burns,2014,40(1):e4-7.DOI: 10.1016/j.burns.2013.06.017.
    [15]
    刘安,秦秀龙,马慧勇.髂腹股沟分叶皮瓣修复虎口部电烧伤创面[J].长治医学院学报,2007,21(3):205-206.DOI: 10.3969/j.issn.1006-0588.2007.03.018.
    [16]
    王海波,农朋海,李能文,等.游离腹股沟皮瓣修复四肢软组织缺损的临床应用[J].中华显微外科杂志,2022,45(6):622-628.DOI: 10.3760/cma.j.cn441206-20220509-00092.
    [17]
    宋达疆,周波,李赞,等.旋髂浅动脉穿支皮瓣在口腔鳞癌术后修复重建中的解剖基础和临床应用[J].中华整形外科杂志,2022,38(1):40-45.DOI: 10.3760/cma.j.cn114453-20200217-00052.
    [18]
    狄海萍,邢培朋,夏成德,等.游离腹股沟皮瓣修复拇指环形电烧伤的临床研究[J/CD].中华损伤与修复杂志(电子版),2021,16(2):104-108.DOI: 10.3877/cma.j.issn.1673-9450.2021.02.003.
    [19]
    张伟,张卫东,陈斓,等.扩张皮瓣整复大面积烧伤后面颈部瘢痕挛缩畸形的临床效果[J].中华烧伤与创面修复杂志,2023,39(9):826-834.DOI: 10.3760/cma.j.cn501225-20230706-00248.
    [20]
    TomczakS,Abellan-LopezM,de Villeneuve BargemonJB,et al.Reconstruction of penile skin loss by superficial circumflex iliac perforator (SCIP) pedicled flap after Fournier's gangrene[J].Ann Chir Plast Esthet,2023:S0294-1260(23)00073-0.DOI: 10.1016/j.anplas.2023.06.012.
    [21]
    HongJP.The superficial circumflex iliac artery perforator flap in lower extremity reconstruction[J].Clin Plast Surg,2021,48(2):225-233.DOI: 10.1016/j.cps.2020.12.005.
    [22]
    CherubinoM,StoccoMDC,SallamMDD,et al.Superthin SCIP flap for reconstruction of subungual melanoma: aesthetic functional surgery[J].Plast Reconstr Surg,2018,142(5):807e-808e.DOI: 10.1097/PRS.0000000000004940.
    [23]
    TawaP,LévyJ,BraultN,et al.Lambeau libre SCIP en reconstruction pédiatrique : à propos d'un cas[J].Ann Chir Plast Esthet,2020,65(4):338-342.DOI: 10.1016/j.anplas.2019.11.001.
    [24]
    BernerJE,NikkhahD,ZhaoJ,et al.The versatility of the superficial circumflex iliac artery perforator flap: a single surgeon's 16-year experience for limb reconstruction and a systematic review[J].J Reconstr Microsurg,2020,36(2):93-103.DOI: 10.1055/s-0039-1695051.
    [25]
    赵建强,车永琦,王军成,等.一蒂多分叶髂腹股沟皮瓣修复多手指皮肤缺损[J].中华手外科杂志,2012,28(6):375.DOI: 10.3760/cma.j.issn.1005-054X.2012.06.025.
    [26]
    Fernandez-GarridoM,Nunez-VillaveiranT,ZamoraP,et al.The extended SCIP flap: an anatomical and clinical study of a new SCIP flap design[J].J Plast Reconstr Aesthet Surg,2022,75(9):3217-3225.DOI: 10.1016/j.bjps.2022.06.021.
    [27]
    顾荣,王海文,江新民,等.髂腹股沟联体穿支皮瓣移植修复上肢较大面积皮肤缺损[J].中华显微外科杂志,2017,40(5):433-437.DOI: 10.3760/cma.j.issn.1001-2036.2017.05.005.
    [28]
    王海文,顾荣,江新民,等.髂腹股沟嵌合穿支骨皮瓣修复四肢骨和软组织缺损的临床应用[J].中华显微外科杂志,2019,42(1):32-36.DOI: 10.3760/cma.j.issn.1001-2036.2019.01.009.
    [29]
    ZublerC,HaberthürD,HlushchukR,et al.The anatomical reliability of the superficial circumflex iliac artery perforator (SCIP) flap[J].Ann Anat,2021,234:151624.DOI: 10.1016/j.aanat.2020.151624.
    [30]
    喜雯婧,冯少清,李华,等.旋髂浅动脉穿支皮瓣的重新评价和手术策略[J].中华显微外科杂志,2018,41(4):313-318.DOI: 10.3760/cma.j.issn.1001-2036.2018.04.001.
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