应用多种皮瓣修复同一肢体部位多发性电烧伤创面的临床研究

Clinical studies on multiple wound of the same body parts repairs through combined application of different types of skin flaps

目的探讨修复同一肢体部位多发性电烧伤创面的手术方案。方法自2011年9月至2013年10月,济南军区总医院烧伤整复科共处理18例同一肢体多发电烧伤创面患者,根据创面情况,综合应用游离或带蒂皮瓣、多种复合皮瓣及动脉穿支皮瓣,辅以皮片移植进行修复。结果18例患者术中共转移皮瓣65个,其中62个皮瓣成活良好,伤口愈合佳,2个皮瓣出现远端淤血坏死,1个皮瓣出现感染切口裂开,经换药治疗后均二期愈合。随访3个月到3年,皮瓣质地、弹性、色泽均良好,局部功能恢复好,效果理想。结论对于同一肢体部位多发性电烧伤创面,根据创面情况,综合应用多种皮瓣技术,能最大程度实现功能的恢复。

Objective To investigate the surgery method to repair multiple wound of the same body parts.Methods All 18 cases of electrical burn patients with multiple wound of the same body parts were cured from September 2011 to October 2013.Integrated application of free or pedicle flap,a variety of composite flap,arterial perforators flap and skin grafts were used to repair in the surgery,according to the wound situation.Resluts All 65 flaps were transfered in the 18 cases sugery,of which 62 flaps survived and wound healed well,congestion necrosis in 2 flaps distal parts,infection incision dehiscence appeared in 1 skin flap.All received secondary wound healing after wound dressing.With the follow up of 3 months to 3 years,skin flap texture,flexibility and color were good and received good functional recover.Conclusion Integrated application of different types of skin flaps to treat multiple electrical wound of the same body parts can receive the maximum function recovery.