【摘要】 目的 探讨含肌瓣的股前外侧嵌合穿支皮瓣修复腕部高压电烧伤创面的临床效果。方法 采用回顾性观察研究的方法，选取2016年1月至2023年4月首都医科大学附属北京积水潭医院收治的45例Ⅱ型腕部高压电烧伤患者，均为男性，年龄20～61岁，平均（38.1±11.3）岁。伤后早期行腕部切开减张术，伤后2～7 d彻底清创，采用携带股外侧肌或股直肌的股前外侧嵌合穿支皮瓣游离移植修复腕部创面，皮瓣切取面积为15 cm×8 cm～24 cm×11 cm，肌瓣大小为5 cm×3 cm×2 cm～7 cm×4 cm×3 cm，供瓣区直接拉拢缝合。术后观察皮瓣成活情况、皮瓣伤口愈合情况及供瓣区伤口情况，随访时观察受区皮瓣外形及手功能恢复情况、供瓣区愈合情况。结果 45例患者术后股前外侧穿支嵌合皮瓣均成活，皮瓣伤口及供瓣区伤口一期愈合。随访5～12个月，腕部皮瓣质地、颜色良好，不臃肿，供瓣区伤口愈合后呈线性瘢痕，手指屈曲功能恢复良好。结论 伤后早期切开减张、彻底清创、应用含肌瓣的股前外侧嵌合穿支皮瓣游离移植修复Ⅱ型腕部高压电烧伤创面效果良好。更多还原

【Abstract】 Objective To investigate the effectiveness of using the chimeric anterolateral thigh perforator flap with muscle flap for repairing high-voltage electric burns on the wrist. Method A retrospective observational study was conducted on 45 male patients(aged 20-61years) with high-voltage(10-100kV) electric burns on the wrist, who were admitted to Beijing Jishuitan Hospital, Capital Medical University from January 2016 to April 2023. In the early stage after injury, patients underwent open reduction and internal fixation procedures on the wrist, followed by thorough debridement 2-7 days after injury. A chimeric anterolateral thigh perforator flap with muscle flap carrying either the anterolateral thigh muscle or the rectus femoris muscle was used for the free transplantation to repair the wound on the wrist. The flap size ranges from 15 cm×8 cm to 24 cm×11 cm, and the muscle flap size ranges from 5 cm×3 cm×2 cm to 7 cm×4 cm×3 cm. Direct approximation and suturing were performed on the donor site. Postoperatively, the survival of the flap, wound healing of the flap, and the donor site were observed. During follow-up, the appearance of the flap in the recipient area, the recovery of hand function, and the healing of the donor site were observed. Result After the operation, all 45 patients had successful survival of the chimeric anterolateral thigh perforator flap with muscle flap, with primary wound healing for both the flap and the donor site. During a follow-up period of 5 to 12 months, the texture and color of the flap on the wrist remained good, without swelling, and the donor site showed linear scars. Finger flexion function recovered well. Conclusion Early open reduction and internal fixation, thorough debridement, and free transplantation of the chimeric anterolateral thigh perforator flap with muscle flap effectively repaired type II high-voltage electric burns on the wrist, providing good results.更多还原