Objective: To investigate the effects of flap or myocutaneous flap combined with fascia lata or composite mesh on repairing wounds in abdomen of patients with severe high-voltage electrical burn. Methods: From January 2010 to May 2017, 11 patients with severe high-voltage electrical burn in abdomen were hospitalized in our burn wards. In 3 hours to 7 days after burn, operation was performed when patients were in stable condition. After debridement, intestines with necrosis or perforation in 4 patients with peritoneal defects were resected and intestinal anastomosis was performed. The size of abdominal wounds after debridement ranged from 13 cm×9 cm to 41 cm×32 cm. Five patients were treated with rectus abdominis myocutaneous flap and size of which ranged from 14 cm×10 cm to 30 cm×17 cm. Among the above 5 patients, 4 patients with peritoneal defects used composite mesh of 25 cm×20 cm to enhance abdominal wall. Three patients were treated with tensor fascia lata myocutaneous flap, and size of the flap ranged from 24 cm×10 cm to 27 cm×13 cm. Three patients were treated with anterolateral thigh flap with fascia lata, and one of them was treated with the lobulated flap; size of the flap ranged from 18 cm×13 cm to 25 cm×15 cm. The later 6 patients used fascia lata of flap to enhance abdominal wall. The donor sites were sutured directly or repaired with intermediate split-thickness skin graft of thigh. Results: After operation, flaps or myocutaneous flaps of patients were survived, and strength of abdominal wall recovered. During follow-up of 6 month to 1 year, flaps or myocutaneous flaps were in good appearance, with no ankylenteron or abdominal wall hernia. Conclusions: Flap or myocutaneous flap combined with fascia lata or composite mesh can achieve good effects on repairing severe high-voltage electrical burn wounds in abdomen.
目的： 探讨皮瓣或肌皮瓣联合阔筋膜或复合补片修复患者严重腹部高压电烧伤创面的效果。 方法： 2010年1月—2017年5月，笔者单位收治11例严重腹部高压电烧伤患者，患者于伤后3 h～7 d在全身情况相对稳定下行手术。清创后见本组4例患者腹膜损伤伴肠坏死或穿孔，切除坏死或穿孔肠管并行肠吻合术。本组患者清创后腹部创面面积为13 cm×9 cm～41 cm×32 cm。采用腹直肌肌皮瓣修复5例，肌皮瓣面积为14 cm×10 cm～30 cm×17 cm，其中4例腹膜缺损的患者同时使用复合补片加强腹壁，补片面积为25 cm×20 cm。采用阔筋膜张肌肌皮瓣修复3例，肌皮瓣面积为24 cm×10 cm～27 cm×13 cm；采用携带阔筋膜的股前外侧皮瓣修复3例，其中1例患者设计分叶皮瓣修复，皮瓣面积为18 cm×13 cm～25 cm×15 cm，此6例患者利用皮瓣中的阔筋膜加强腹壁。供瓣区直接缝合或取大腿中厚皮修复。 结果： 术后患者皮瓣或肌皮瓣全部成活，腹壁强度恢复。随访6个月～1年，皮瓣或肌皮瓣外形良好，未出现肠粘连、腹壁疝等。 结论： 皮瓣或肌皮瓣联合阔筋膜或复合补片修复严重腹部高压电烧伤创面，效果较佳。.
Keywords: Abdomen; Burns, electric; Composite mesh; Fascia lata; Surgical flaps.