Archives of Plastic Surgery

  • 제35권1호
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  • Pages.67-72
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  • 2008
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  • 2234-6163(pISSN)
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  • 2234-6171(eISSN)
대한성형외과학회 (Korean Society of Plastic and Reconstructive Surgeons)
권호 표지

고압 전기화상에 의한 수부 손상 시 비골동맥 천공지 유리피판술을 이용한 재건

Reconstruction of Hand Using Peroneal Perforator Free Flap in High-Voltage Electrical Burn Patients

  • 김동훈 (한일병원 성형외과학교실) ;
  • 유중석 (한일병원 성형외과학교실) ;
  • 임준규 (한일병원 성형외과학교실) ;
  • 이동락 (한일병원 성형외과학교실)
  • Kim, Dong Hoon (Department of Plastic and Reconstructive Surgery, Hanil General Hospital) ;
  • Yoo, Jung Seok (Department of Plastic and Reconstructive Surgery, Hanil General Hospital) ;
  • Lim, Jun Kyu (Department of Plastic and Reconstructive Surgery, Hanil General Hospital) ;
  • Lee, Dong Lark (Department of Plastic and Reconstructive Surgery, Hanil General Hospital)
  • 투고 : 2007.06.11
  • 발행 : 2008.01.10
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: The hand is frequently affected area in high voltage electrical burn injury as an input or output sites. Electrical burn affecting the hand may produce full thickness necrosis of the skin and damage deep structures beneath the eschar, affecting the tendon, nerve, vessel, even bone which result in serious dysfunction of the hand. As promising methods for the reconstruction of the hand defects in electrical burn patients, we have used the peroneal perforator free flaps. Methods: From March 2005 to June 2006, we applied peroneal perforator free flap to five patients with high tension electrical burn in the hand. Vascular pedicle ranged from 4cm to 5cm and flap size was from $4{\times}2.5cm$ to $7{\times}4cm$. Donor site was closed primarily.Results: All flaps survived completely. There was no need to sacrifice any main artery in the lower leg, and there was minimal morbidity at donor site. During the follow-ups, we got satisfactory results both in hand function and in aesthetic aspects.Conclusion: The peroneal perforator flap is a very thin, pliable flap with minimal donor site morbidity and is suitable for the reconstruction of small and medium sized wound defect, especially hand with electrical burn injury.

키워드

참고문헌

  1. Sharzer LA, O'Brien BM, Horton CE, Adamson JE, Mladick RA, Carraway JH, Hayhurst JW, McLeod A: Clinical applications of free flap transfer in the burn patient. J Trauma 15: 766, 1975 https://doi.org/10.1097/00005373-197509000-00003
  2. Lee HS, Kim YS, Lee HW: A clinical review of the high-tension electrical burns. J Korean Soc Plast Reconstr Surg 22: 1473, 1995
  3. Robson MC, Murphy RC, Heggers JP: A new explanation for the progressive tissue loss in electrical injuries. Plast Reconstr Surg 73: 431, 1984 https://doi.org/10.1097/00006534-198403000-00017
  4. Zelt RG, Daniel RK, Ballard PA, Brissette Y, Heroux P: High-voltage electrical injury: chronic wound evolution. Plast Reconstr Surg 82: 1027, 1988 https://doi.org/10.1097/00006534-198812000-00014
  5. Kim KS, Song HS, Na MW, Lee TS, Lee DE: Reconstruction of wrist defects with free flaps in high tension electrical burn patients. J Korean Soc Plast Reconstr Surg 28: 531, 2001
  6. Maruyama Y: The reverse dorsal metacarpal flap. Br J Plast Surg 43: 24, 1990 https://doi.org/10.1016/0007-1226(90)90041-W
  7. Bene NB, Petrolati M, Raimondi P, Tremolada C, Muset A: Reverse dorsal digital island flap. Plast Reconstr Surg 93: 552, 1994 https://doi.org/10.1097/00006534-199493030-00017
  8. Kim SH, Lee JH, Lee DE: Reconstruction of soft tissue defect in hand using reverse dorsal digital and metacarpal artery island flap in electrical burn patient. J Korean Soc Plast Reconstr Surg 30: 750, 2003
  9. Pelissier P, Casoli V, Bakhach J, Martin D, Baudet J: Reverse dorsal digital and metacarpal flaps: a review of 27 cases. Plast Reconstr Surg 103: 159, 1999 https://doi.org/10.1097/00006534-199901000-00025
  10. Yang D, Morris SF: Reversed dorsal digital and metacarpal island flaps supplied by the dorsal cutaneous branches of the palmar digital artery. Ann Plast Surg 46: 444, 2001 https://doi.org/10.1097/00000637-200104000-00017
  11. Yoshimura M, Imura S, Shimamura K, Yamauchi S, Nomura S: Peroneal flap for reconstruction in the extremity: preliminary report. Plast Reconstr Surg 74: 402, 1984 https://doi.org/10.1097/00006534-198409000-00013
  12. Chen YL, Zheng BG, Zhu JM, Zheng BX, Gu YD, Wu MM, Li HR: Microsurgical anatomy of the lateral skin flap of the leg. Ann Plast Surg 15: 313, 1985 https://doi.org/10.1097/00000637-198510000-00007
  13. Beppu M, Hanel DP, Johnston GHF, Carmo JM, Tsai TM: The osteocutaneous fibula flap: an anatomic study. J Reconstr Microsurg 8: 215, 1992 https://doi.org/10.1055/s-2007-1006703
  14. Kawamura K, Yajima H, Kobata Y, Shigematsu K, Takakura Y: Clinical applications of free soleus and peroneal perforator flaps. Plast Reconstr Surg 115: 114, 2005