Study on the repair of destructive wounds caused by multi-site electrical burns
Objective To explore the repair method of multi-site destructive electrical burn wounds.Methods The clinical data of 38 patients with multiple-site destructive electrical burns admitted to the Burns Department of Beijing Jishuitan Hospital,Capital Medical University from September 2016 to October 2022 were retrospectively analysed,including 37 males and 1 female,aged 9-61 years,with an average age of 37 years.The injury voltage was 6-35 kV in 37 cases and 380 V in 1 case.There were 5 cases involving two parts,and 33 cases involving three or more parts.Early comprehensive evaluation of the patient's condition and systemic support treatment were carried out.If vital organ injuries were involved,closed thoracic drainage,and necrotic lung tissue,necrotic perforated intestinal resection be performed.When electrical burns of limbs,especially wrists were involved,emergency wrist incision was performed to reduce tension,and venous bridging of the ulnar radial artery was needed to save limbs if blood supply was not improved.According to the location and injury degree of the destructive wounds,reasonable operation timing was arranged,and suitable flaps were used to repair the wounds.Results Among the 38 patients,37 patients had good results and 1 patient died.There were 17 cases of burns involving limbs and trunk(chest,abdomen,back,head),and 21 cases only involving limbs.There were 13 free paraumbilical perforator flaps pedicled with the inferior epigastric artery,23 free anterolateral thigh flaps,4 island inferior trapezius myocutaneous flaps,2 free latissimus dorsi myocutaneous flaps,7 pedicled latissimus dorsi myocutaneous flaps,3 pedicled rectus abdominis myocutaneous flaps,1 pedicled tensor fasciae latae myocutaneous flap,4 pedicled anterolateral thigh flaps,3 free medial sural flaps,1 intercostal artery perforator flap,1 free medial upper arm flap,1 free lateral metatarsal flap,1 free superficial peroneal artery perforator flap and 3 local flaps.All flaps survived.During the follow-up of 3-18 months,the repair effect of destructive wounds were good.There was no abdominal wall hernia in patients with abdominal wall wounds.Fifteen patients were re-admitted for tendon reconstruction and flap repair.Four patients with scalp flaps were placed with scalp expanders to repair alopecia.Conclusion For patients with multi-site destructive electrical burns,different parts,tissues and organs should be treated differently.Save lives first,then preserve limbs,according to the location and injury degree of the destructive wounds,arrange reasonable surgical timing and surgical plan.Cooperate with doctors in relevant departments to better carry out wound repair and functional reconstruction,and reduce disability rate.
万方数据
维普
