Extended Paraumbilical Perforator Flap Pedicled With the Inferior Epigastric Artery for Coverage of Type III Circumferential Electrical Burns of the Wrist.

Publisher: Oxford University Press Country of Publication: England NLM ID: 101262774 Publication Model: Print Cited Medium: Internet ISSN: 1559-0488 (Electronic) Linking ISSN: 1559047X NLM ISO Abbreviation: J Burn Care Res Subsets: MEDLINE

Publication: 2018- : Oxford : Oxford University Press
Original Publication: Hagerstown, MD : Lippincott Williams & Wilkins, c2006-

Perforator Flap*/blood supply ; Burns, Electric*/surgery ; Burns*/surgery ; Soft Tissue Injuries*/surgery; Humans ; Male ; Young Adult ; Adult ; Wrist/surgery ; Skin Transplantation ; Epigastric Arteries/surgery ; Necrosis/surgery ; Treatment Outcome

Type III electrical burns on the wrist are characterized by circumferential wounds, three dimensional with sandwich-like necrosis, and progressive blood circulation disturbances. Limb salvage is challenging, and success in meeting this challenge depends on vascular reconstruction and wound coverage. This article is intended for the following purposes: to investigate the principles of wound debridement, the management of involved blood vessels, and the clinical effects of the extended paraumbilical perforator flap pedicled with the inferior epigastric artery for coverage of type III circumferential electrical burns of the wrist. A total of 13 male patients (age, 20 to 43 years; average, 29 years) were enrolled in the study. After early escharotomy, debridement, and vascular reconstruction, all wounds were repaired with the extended paraumbilical perforator flap pedicled with the inferior epigastric artery. Flap survival was achieved in all 13 patients. Subcutaneous liquefaction necrosis and infection beneath the flap occurred in three patients. Radial or ulnar artery reconstruction via the great saphenous vein (GSV) graft was performed in 12 cases. All patients had a mean follow-up of 6 to 36 months, and the flaps demonstrated satisfactory flexibility and texture. Hand function was preserved in eight patients, and no patients developed abdominal hernia. Thorough debridement, early vascular reestablishment, and wound coverage are essential for the overall limb salvage effort for type III circumferential electrical burns of the wrist. The extended paraumbilical perforator flap may provide a new and appropriate option for the primary repair of extensive soft tissue defects.
(© The Author(s) 2023. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For permissions, please e-mail: [email protected].)

Date Created: 20230817 Date Completed: 20231108 Latest Revision: 20231112

20231215

10.1093/jbcr/irad108

37590974