Application of vascularized perforant flaps in the hand restoration in electro-thermic affections

Keywords: electric burns of the hand; perforant insular flaps of the hand.

Abstract

Objective. To improve the results of surgical treatment in patients with deep electric burns of the hand, using local vascularized flaps, based on perforant vessels.

Materials and methods. Analysis of the treatment results in 17 patients, suffering electric trauma of the hand was conducted, the defects plasty was performed, using local vascularized flaps, based on perforant vessels of the hand.

Results. In 17 patients 20 flaps were formed. Application of revascularization procedures have permitted to obtain good results in immediate period in 76.5% patients, and satisfactory - in 13.5% patients, in late follow-up period good results - in 88.2% patients, and satisfactory - in 11.8% patients.

Conclusion. The transplant, owing own blood circulation and locally vascularized flaps, based on perforant vessels, which are formed on non-injured parts of the hand, guarantee the blood supply restoration in the zone of electric thermic affection as well as the wound defect closing.

Author Biographies

A. O. Zhernov, Kyiv’s Municipal Clinical Hospital No 2

Zhernov A. O. - MD, PhD (Med),
Head of Department Burn Plastic surgery
Kiev City Clinical Hospital No. 2
13 Krakivska str., Kyiv, 02094, Ukraine
+38 067 25730 38
burnclinic.kiev@gmail.com
https://orcid.org/0000-0001-5096-5220

O. M. Kovalenko, Bogomolets National Medical University, Kyiv

Kovalenko Olga M. - MD, DSci (Med), Professor.
Professor Department of Surgery No 1,
Bogomolets National Medical University, Kyiv, Ukraine
+38 099 499 45 74
profkovalenko2020@gmail.com
http://orcid.org/0000-0002-9636-5383

O. A. Zhernov, Shupik National Medical Academy of Postgraduate Education, Kyiv

Zhernov O. A. - MD, PhD, Associate Professor
Professor Department of combustiology and plastic surgery
Shupik National University Healthcare of Ukraine, Kyiv,
oazhernov@gmail.com
13 Krakivska str., Kyiv, 02094, Ukraine
+38 (067) 730 6099.
ORCID: http://orcid.org/0000-0002-5263-5281

References

Xie WG. [Prevention and treatment of electrical burn injury: much progresses achieved yet further efforts still needed]. Zhonghua Shao Shang Za Zhi. 2017 Dec 20;33(12):728-31. Chinese. doi: 10.3760/cma.j.issn.1009-2587.2017.12.002. PMID: 29275612.

Brandão C, Vaz M, Brito IM, Ferreira B, Meireles R, Ramos S, et al. Electrical burns: a retrospective analysis over a 10-year period. Ann Burns Fire Disasters. 2017 Dec 31;30(4):268-71. PMID: 29983679; PMCID: PMC6033477.

Shen YM. [Wound repair and functional reconstruction of high-voltage electrical burns]. Zhonghua Shao Shang Za Zhi. 2018 May 20;34(5):257-62. Chinese. doi: 10.3760/cma.j.issn.1009-2587.2018.05.001. PMID: 29804422.

Wen YZ, Zhang PH, Ren LC, Zhang MH, Zeng JZ, Zhou J, et al. [Clinical characteristics and repair effect of 136 patients with electric burns of upper limb]. Zhonghua Shao Shang Za Zhi. 2019 Nov 20;35(11):784-9. Chinese. doi: 10.3760/cma.j.issn.1009-2587.2019.11.004. PMID: 31775466.

Hashimoto I, Abe Y, Ishida S, Kashiwagi K, Mineda K, Yamashita Y, et al. Development of Skin Flaps for Reconstructive Surgery: Random Pattern Flap to Perforator Flap. J Med Invest. 2016;63(3-4):159-62. doi: 10.2152/jmi.63.159. PMID: 27644551.

Gupta P, Tawar RS, Malviya M. Groin Flap in Paediatric Age Group to Salvage Hand after Electric Contact Burn: Challenges and Experience. J Clin Diagn Res. 2017 Aug;11(8):PC01-PC03. doi: 10.7860/JCDR/2017/29124.10332. Epub 2017 Aug 1. PMID: 28969190; PMCID: PMC5620831.

Slesarenko SV, Badyul PA. Single-stage reconstruction of soft-tissue defects of fingers by local mesh island flaps. Issues of Reconstructive and Plastic Surgery. 2018;(4):20-5. Russian. doi: 10.17223/1814147/67/03 [in Russian]

Galich SP, Furmanov AYu, Reznikov AV, Dabizha AYu. Reconstruction of the thumb soft tissue defects by using first dorsal metacarpal artery flap. Plastic, reconstructive and aesthetic surgery (Kyiv). 2017;(3-4):11-6. Russian.

Georgescu AV, Matei IR. Propeller perforator flaps in forearm and hand reconstruction. Eur J Orthop Surg Traumatol. 2019 Feb;29(2):357-66. doi: 10.1007/s00590-018-2323-7. Epub 2018 Oct 26. PMID: 30367281.

Depamphilis MA, Cauley RP, Sadeq F, Lydon M, Sheridan RL, Driscoll DN, Winograd JM. Surgical management and epidemiological trends of pediatric electrical burns. Burns. 2020 Mar 31:S0305-4179(19)30619-9. doi: 10.1016/j.burns.2020.03.005. Epub ahead of print. PMID: 32245570.

Published
2020-12-28
Section
General Problems of Surgery