[Repair of circumferential wound in the wrist region due to high-voltage electrical burn using combined abdominal axial pattern flaps].

Objective: To explore the method for repairing circumferential wound in the wrist region due to high-voltage electrical burn.

Methods: Six patients with circumferential wound in the wrist region after high-voltage electrical burn were admitted to our hospital from January 2009 to December 2011. After debridement, wounds in the wrist were repaired with combined abdominal axial pattern flaps. The wound of wrist on the flexor aspect was repaired with paraumbilical flap carrying a portion of rectus abdominis that filled the wound cavity of the wrist on the flexor aspect. The wound of wrist on the dorsal aspect was repaired with lower abdominal flap. Pedicle division was performed 4 - 5 weeks post surgery. Some donor sites were sutured directly, and the others were closed by skin grafting after the suture of anterior sheath.

Results: Three flaps survived. Liquefaction necrosis of tissue was observed under two flaps, and they were healed after debridement. Radial artery embolism of wrist occurred in one flap when pedicle division was performed 5 weeks post surgery, and it was healed by a transplantation of a segment of the great saphenous vein to reconstruct radial artery right after debridement. Patients were followed up for 6 - 12 months, and satisfactory appearance and function of the flaps were observed.

Conclusions: It is a feasible option to repair circumferential wound in the wrist region due to high-voltage electrical burn by using paraumbilical flap carrying a portion of rectus abdominis muscle combined with lower abdominal flap.