Fifty-four patients (50 males and 4 females, aged from 10 to 56 years) with high-voltage
electric burn wounds in 97 limbs (67 upper limbs and 30 lower limbs) were hospitalized in our
burn wards from January 2003 to December 2010. A total of 119
burn wounds in wrist-forearm, forearm-elbow-upper arm, shoulder-axillary region, ankle-foot, lower leg, around the knee, thigh-inguinal region were treated with incision for
decompression within 10 days after
burn. Under the premise of relatively stable systemic condition of the patients, certain surgical operations were performed as follows. (1) Sixteen limbs with 16
wounds were amputated, among them forearm
amputation was performed for 5 upper limbs with
necrosis, with preservation of elbow joints, and the residual
wounds of the elbow and upper arm were repaired with pedicled latissimus dorsi musculo-cutaneous flaps; 1 upper limb with upper arm amputated, with preservation of shoulder joint, was repaired with pedicled latissimus dorsi musculo-cutaneous flap. (2) Ninety-five
wounds were covered with various tissue flaps with abundant blood supply after early
debridement, in which 3 brachial arteries, 1 vein, 1 brachial artery and vein were reconstructed in 5 wrist
wounds, artery reconstruction was performed in elbow
wound of 1 case with injured brachial artery. (3) Eight
wounds were treated with free
skin grafting. Wound healing conditions were observed and followed up.
RESULTS:
Wounds in 16 limbs healed after
amputation and repair. Blood supply and (or) venous return of hands were restored in 5 wrist
wounds after vessel reconstruction. After artery reconstruction, abundant blood supply was observed in 1 case with injured brachial artery and
amputation was avoided.
Necrosis occurred in distal parts of tissue flaps in 5
wounds after grafting, in which 2
wounds healed after removal of necrotic tissue followed by closure with
suture, and 3
wounds healed after
debridement and free
skin grafting. Tissue flap
infection occurred in wrist (5
wounds), elbow (1
wound), ankle-foot (2
wounds), and healed after
debridement and
suture. The other tissue flaps survived after grafting. Six
wounds healed after
skin grafting. Partial
necrosis occurred in 2
wounds after
skin grafting, and they were healed after second
skin grafting. Thirty-seven patients were followed up for 6 to 12 months, the skin flaps survived with satisfactory appearance and texture.
CONCLUSIONS: