【摘要】 目的探讨应用肌皮瓣修复上肢高压电烧伤深度创面的临床治疗效果。方法选取2010年1月至2017年12月北京积水潭医院烧伤科收治的48例上肢高压电烧伤患者,所有创面清创后均采用肌皮瓣修复,其中32例上臂及肘关节创面患者采用背阔肌肌皮瓣修复,16例前臂及腕部创面患者采用游离股前外侧肌皮瓣修复,观察术后肌皮瓣成活情况及供区修复情况。结果 43例患者术后皮瓣完全成活,供区愈合良好。5例(3例背阔肌皮瓣修复患者、2例游离股前外侧肌皮瓣修复患者)远端部分坏死,换药后植皮覆盖;供区愈合良好。所有患者均获3~12个月的随访,随访期间皮瓣外观良好,供瓣区留有瘢痕。结论对于上肢高压电深度烧伤患者,采用背阔肌肌皮瓣修复上臂及肘部创面、游离股前外侧肌皮瓣修复前臂和腕部创面具有较好的临床效果。背阔肌肌皮瓣还能够进行肘部功能重建,可最大程度地恢复肘关节功能。更多还原

【Abstract】 Objective To investigate the treatment of deep wounds of upper limbs using myocutaneous flaps after high-voltage electrical burn. Method A retrospective study was performed on 48 cases of patients with deep burn wound of upper limbs after high-voltage electrical burn form January 2010 to December 2017. All wounds of patients were repaired with mycutaneous flaps after debridement, including 32 cases were repaired with latissimus dorsi myocutaneous flaps and 16 cases were repaired with anterolateral thigh free flaps. Survival of flaps and healings of donor sites were observed. Result The postoperative myocutaneous flaps of 43 patients were fully alive,and the donor area healed well.5 flaps(3 latissimus dorsi myocutaneous flaps and 2 anterolateral thigh free flaps) were suf fered with distal flap necrosis, and recovered by skin graft. All patients were followed up for 3 to 12 months, the flaps were smooth and not swollen, the appearance was good, the flap area was left with a strip scar. Conclusion Latissimus dorsi myocutaneous flaps are good choices for repairing deep wound of elbow, and anterolateral thigh free flaps are good choices for repairing deep burn wound of wrist after high-voltage electrical burn. The latissimus dorsi musculocutaneous flap can also reconstruct the function of elbow joint.更多还原