肋间后动脉外侧穿支蒂皮瓣修复上肢电损伤创面

Repair of electric bum wound in the upper limbs with lateral intercostal pedorator-based pedicled flap

目的建立以肋间后动脉外侧穿支为血供的带蒂腹部皮瓣覆盖上肢电损伤创面的手术方法，观察其应用效果。方法应用以第7～10肋间穿支血管供养的腹部皮瓣，修复6例电损伤患者肘部、前臂、腕部、手掌部创面。皮瓣面积16．0cm×12．0cm～9．0cm×7．0cm，移植皮瓣18．21d后断蒂。观察皮瓣的成活情况及外观。结果肋间后动脉外侧穿支蒂皮瓣血供可靠，手术操作简便、耗时短。5例皮瓣移植后全部成活；1例皮瓣因切取时超过脐旁线，致远端边缘3．5cm×2．0cm部分坏死。术后外观满意。结论肋间后动脉外侧穿支蒂皮瓣适用于前臂、肘部及手部损伤创面的修复。

Objective To describe an operative method for the repair of electric burn wound in the upper limbs with lateral intercostal perforator-based pedicled flap, and to observe its clinical effect. Methods Intercostal artery perforator-based pedicled abdominal flap with the blood supply originating from the lateral perforator branches of the 7^th-10^th intercostal arteries were used to repair the wounds of 6 patients with burn wounds in elbows, forearm, wrists and palms. The pedicles were （16.0 cm × 12.0 cm） ～ （9.0 cm ×7.0 cm） in area, and the pedicles were severed 18 to 21 days after the operation. The survival and the appearance of the flaps were observed after operation. Results The procedure was easy and safe, and there was reliable and adequate blood supply in the lateral intercostal perforator-based pedicled flap. All the flaps survived in 5 patients, except marginal necrosis （ 3.5 cm × 2.0 cm） was found in the distal portion of flap because flap cutting exceeded the paraumbilical line. The appearance was satisfactory after operation. Conclusion This flap is suitable for the repair of deep wounds in hands, forearms, and elbows.