摘要
目的 探讨四肢电烧伤创面皮瓣修复的修复方法和手术适应证. 方法 1997年5月-2014年6月,共收治四肢电烧伤后软组织缺损患者38例,分别于电烧伤后7～14d内采用了皮瓣修复,其中局部旋转皮瓣4例,鱼际皮瓣1例,示指背侧皮瓣2例,交腿皮瓣1例,足底内侧皮瓣1例,带蒂背阔肌皮瓣2例,前臂骨间后动脉逆行岛状皮瓣4例,掌背动脉逆行岛状皮瓣4例,髂腹股沟皮瓣10例;游离桡动脉皮瓣1例,游离背阔肌皮瓣1例,游离股前外侧皮瓣3例;前臂后侧骨间前动脉穿支逆行岛状皮瓣1例,小腿后侧穿支逆行岛状皮瓣2例,小腿前外侧穿支逆行岛状皮瓣1例.皮瓣切取范围42.0 cm×13.0 cm～6.0 cm×3.0 cm.结果 术后随访时间4～42个月,平均6、7个月.皮瓣完全成活35例,占92.1％;尖端部分坏死3例,占7.9％.坏死部分经局部换药均在术后1个月内自行愈合.肢体和手的外形较为满意,手腕部电烧伤病例28例,功能优和良共15例,占57.1％;中8例,占28.6％;差5例,占14.3％. 结论 对电烧伤创面进行早期皮瓣修复,是保护肢体深部组织结构、预防控制继发感染、最大限度保留肢体功能的有效方法。
Objective To investigate the surgical indications and repair methods for the treatment of electrical bums in the limbs.Methods Thirty-eight cases since May,1997 to June,2014 who underwent flap treatment in 7-14 days after electrical bums was summarized.Among these patients,4 cases were treated by local flaps,1 case was treated by thenar flap,2 cases were treated by dorsal island skin flap of the index finger,1 case was treated by cross-leg flap,1 case was treated by medial plantar skin flap;2 cases were treated by pedicle latissimus dorsi flaps,4 cases were treated by antebrachial flap with a pedicle of the posterior interosseous artery,4 cases were treated by metacarpal artery reversed island flaps,10 cases were treated by groin flaps;1 case was treated by free radial artery flap,1 case was treated by free latissimus dorsi flap,3 cases were treated by free anterolateral thigh flaps;1 case was treated by reverse island forearm posterior interosseous flap,2 cases were treated by posterior perforator reversed island flaps of the lower leg,1 case was treated by anterolateral perforator reversed island flaps of the lower leg.The area of flap was from 42.0 cm × 13.0 cm to 6.0 cm × 3.0 cm.The survival rate of the flap,the appearance and function of limb were observed.Results All these patients were followed up from 4 months to 3 years 6 months,the mean time was 6 months and 20 days.Thirty-five flaps survived completely,accounting for 92.1%,and 3 cases suffered partial necrosis at the distal end,accounting for 7.9%.Secondary healing was achieved by dress changing.The appearance of the limbs was satisfactory.Among the 28 cases whose bums were on the hands,the total number of excellent and good was 15,medium was 8,and 5 poor cases.The excellent and good rate was 57.1%.Conclusion Early repairing of the electrical burns with flaps is the effective method for protecting the deep structures of the limb,preventing and control the secondary infections and preserve the function of the limbs.
出处
《中华显微外科杂志》
CSCD
北大核心
2015年第2期120-122,共3页
Chinese Journal of Microsurgery
基金
国家临床重点专科建设项目（131120002507）
关键词
电烧伤
四肢
外科皮瓣
创面
Electrical bums
Limbs
Surgical flap
Wounds
