Flap Reconstruction for Electrical Injuries

電傷害之皮瓣重建治療

陳恆常(Heng-Chang Chen) ； 董光義(Kwang-Yi Tung) ； 蘇茂仁(Mao-Jen Su) ； 蕭弘道(Hung-Tao Hsiao) ； 劉豪文(Hao-Wen Liu) ； 歐聖運(Shuan-Yuan Ou)

《中華民國重建整形外科醫學會雜誌》 1卷2期 (1992/09) Pp. 97-103

https://doi.org/10.7096/JPRSA.199209.0097

摘要

嚴重電傷害常合併肌腱、骨骼及神經血管暴露而形成治療難題，公認應以早期擴創及早期皮瓣重建手術為其治療方針。局部皮瓣方法簡便，適用範圍較小且鄰近組織正常之傷口，但失敗率仍高。傳統上常使用之帶莖皮瓣如腹部皮瓣等，可提供良好且可靠之皮膚覆蓋，但須歷經不便之手臂固定及多次手術，目前已較少採用。島狀皮瓣及游離皮瓣兼具單次手術完成及術後活動方便之優點，為理想重建方式；惟術前及術中須仔細評估血管狀況，慎選合適之病例。謹此提供馬偕紀念醫院最近五年來六十例電傷害皮瓣重建手術經驗，並探討其適應症。

關鍵字

電傷害 ； 帶莖皮瓣 ； 島狀皮瓣 ； 游離皮瓣

並列摘要

Early debridement and early flap reconstruction are accepted techniques in the primary treatment of severe electircal burns complicated by exposure of tendons, joints, bones and neurovascular structures. Local flaps are used in smaller wounds with otherwise healthy neighboring tissue, and are prone to failure. Pedicle flaps, particularly of the groin, have in the past provided good quality full thickness skin cover through multiple-stage operations. Both island flaps and free flaps have envolved as a single-stage operation achieving complete primary wound healing and allowing freedom of postoperative movement and nursing. Preoperative and intraoperative evaluation of condition of vessels play an important role in selecting proper cases for such flap reconstruction.
We have presented our five year experience with 60 flaps in 47 electrical injury patients.

並列關鍵字

electrical injury ； pedicle flap ； island flap ； free flap