腹部超薄皮瓣修复小儿手指深度电烧伤创面的效果

Effects of ultrathin abdomen flap on repairing deep electric burn wounds in finger of pediatric pa- tients

目的探讨腹部超薄皮瓣在小儿手指深度电烧伤创面修复中的效果。方法2013年3月—2017年10月，笔者单位收治14例单纯手指深度电烧伤患儿，其中单指电烧伤6例、双指电烧伤5例、3指电烧伤3例，单指创面面积2.0 cm×1.0 cm～3.5 cm×2.0 cm。完善术前检查后，于伤后3～6 d行创面清创及腹部超薄皮瓣修复术，其中6例患儿采用腹部随意型皮瓣，4例患儿采用腹壁下动脉脐旁穿支双叶皮瓣，其余4例患儿采用旋髂浅动脉双叶皮瓣，皮瓣面积为4.0 cm×2.0 cm～8.0 cm×4.0 cm，供瓣区直接拉拢缝合。结果本组患儿术后所有皮瓣均存活良好，无一例出现血运障碍。随访3～24个月，手指外观良好，功能正常，供瓣区恢复良好，未出现瘢痕挛缩畸形。结论腹部超薄皮瓣是修复小儿手指深度电烧伤创面的较佳选择之一。

ObjectiveTo investigate the effects of ultrathin abdomen flap in repairing deep electric burn wounds in finger of pediatric patients.MethodsA total of 14 pediatric patients with simple electric burns in finger were admitted to our unit from March 2013 to October 2017. Six patients had electric burns in one finger, 5 patients had electric burns in two fingers, and 3 patients had electric burns in three fingers. The size of wounds in single finger ranged from 2.0 cm×1.0 cm to 3.5 cm×2.0 cm. After complete preoperative examination, wounds debridement and ultrathin abdomen flap repair operation were performed on 3 to 6 days post injury. Six pediatric patients were treated with abdominal random flap, 4 patients were treated with inferior epigastric artery paraumbilical perforator bilobed flap, and the other 4 patients were treated with superficial circumflex iliac artery bilobed flap. The size of flaps ranged from 4.0 cm×2.0 cm to 8.0 cm×4.0 cm. The donor sites were sutured directly.ResultsThe flaps of 14 pediatric patients survived well after operation, and no flap showed blood supplying disorder. During follow-up of 3 to 24 months, the appearance and function of fingers were good, and the donor sites recovered well, with no cicatrix contracture deformity.ConclusionsThe ultrathin abdomen flap is one of the good choices for repairing deep electric burn wounds in finger of pediatric patients.