Clinical effects of various special forms of the descending branch of the lateral circumflex femoral artery perforator flaps in repairing high-voltage electrical burn wounds on the wrist

Du Weili; Xiong Feng; Che Kexin; Cheng Lin; Dai Qiang; Shen Yuming

doi:10.3760/cma.j.cn501225-20240930-00365

Volume 41 Issue 1

Jan. 2025

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Article Navigation > CHINESE JOURNAL OF BURNS AND WOUNDS > 2025 > 41(1): 18-27

Du WL,Xiong F,Che KX,et al.Clinical effects of various special forms of the descending branch of the lateral circumflex femoral artery perforator flaps in repairing high-voltage electrical burn wounds on the wrist[J].Chin J Burns Wounds,2025,41(1):18-27.DOI: 10.3760/cma.j.cn501225-20240930-00365.

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Clinical effects of various special forms of the descending branch of the lateral circumflex femoral artery perforator flaps in repairing high-voltage electrical burn wounds on the wrist

doi: 10.3760/cma.j.cn501225-20240930-00365

Department of Burns, Beijing Jishuitan Hospital, Capital Medical University, Beijing 100035, China

Funds:

National Key Research and Development Program of China 2018YFA0703104

Capital Health Development Research Project 2020-2-1123

Research and Cultivation Program of Beijing Capital Hospital PX2024016

Discipline Backbone of Beijing Jishuitan Hospital XKGG202209

More Information

Corresponding author: Shen Yuming, Email: shengyuming1963@163.com
Received Date: 2024-09-30

Abstract

Abstract

Objective To explore the clinical effects of various special forms of the descending branch of the lateral circumflex femoral artery (DLCFA) perforator flaps in repairing high-voltage electrical burn wounds on the wrist. Methods This study was a retrospective observational study. From September 2014 to June 2024, 79 male patients with high-voltage electrical burns on the wrist, aged 20 to 62 years and met the inclusion criteria, were admitted to Beijing Jishuitan Hospital Affiliated to Capital Medical University, with wrist high-voltage electrical burn wound (hereinafter referred to as wrist wound) types being classified as type Ⅱ or type Ⅲ. In the early stage after injury, debridement was performed on the patients' wrists. Based on the wound condition and flap indications, the flow-through, lobed, chimeric, flow-through-lobed, lobed-chimeric, flow-through-chimeric, or flow-through-lobed-chimeric DLCFA perforator flap was employed individually, and the flow-through-chimeric DLCFA perforator flap and tensor fascia lata myocutaneous flap were employed in combination to repair the wounds. The donor site wounds were repaired using direct sutures or skin grafting. The number of various DLCFA perforator flaps resected during surgery and the number of various types of wrist wounds repaired were recorded, as well as the closure status of the donor site wound. The postoperative flap survival, occurrence of vascular crisis, wound or suture site healing, and patency of the reconstructed artery in flow-through flaps were recorded. During follow-up, the appearance of the flap, scar formation, and the presence of thigh muscle herniation were observed. Results Intraoperatively, 11 flow-through DLCFA perforator flaps were resected to repair 11 type Ⅱ wrist wounds, 13 lobed DLCFA perforator flaps were resected to repair 9 type Ⅱ and 4 type Ⅲ wrist wounds, 16 chimeric DLCFA perforator flaps were resected to repair 16 type Ⅱ wrist wounds, 11 flow-through-lobed DLCFA perforator flaps were resected to repair 5 type Ⅱ and 6 type Ⅲ wrist wounds, 10 lobed-chimeric DLCFA perforator flaps were resected to repair 5 type Ⅱ and 5 type Ⅲ wrist wounds, 6 flow-through-chimeric DLCFA perforator flaps were resected to repair 6 type Ⅱ wrist wounds, 7 flow-through-lobed-chimeric DLCFA perforator flaps were resected to repair 7 type Ⅲ wrist wounds, and 5 flow-through-chimeric DLCFA perforator flaps combined with tensor fascia lata myocutaneous flaps were resected to repair 5 type Ⅲ wrist wounds. Seventy-four patients had their donor site wounds closed by direct suturing, while 5 patients had their donor site wounds closed by skin grafting. Postoperatively, the flaps in 3 patients developed vascular crisis, including 1 case of arterial crisis and 2 cases of venous crises but survived after emergency vascular exploration and other treatments; the remaining flaps survived completely. Postoperatively, 3 patients had seepage beneath their flaps, which were closed after dressing changes; the remaining patients' wounds or suture sites all healed. Anteriography showed that all reconstructed arteries in 35 patients who underwent flow-through flap transplantation were patent postoperatively. During the follow-up period of 3 months to 1 year, 20 patients had bloated flap, while the rest had good flap appearance; linear scars were left in the donor sites that underwent direct wound closure, and the skin-grafted areas of the donor site wounds showed no significant patchy hypertrophic scarring; no thigh muscle herniation occurred. Conclusions Taking the full advantage of perforator flaps, various special forms of the DLCFA perforator flaps are used to repair the three-dimensionally injury wounds caused by high-voltage electrical burns on the wrist, which not only minimizes the damage to the donor site but also allow the recipient site to be well repaired, showing good appearance in the recent follow-up.
- Burns, electric,
- Wrist injuries,
- Microsurgery,
- Surgical flaps,
- Descending branch of the lateral circumflex femoral artery perforator flap,
- Flow-through flap,
- Chimeric flap,
- Wound repair

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References(40)

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