Combined use of free and pedicled skin flaps for the reconstruction of extremities in high voltage electrical injury.

摘要

Electrocution represents an uncommon but often severe cause of injury. Most of the incidents are work-related and the victims are mostly males. Hands and upper extremities are the main entrance site, while legs and feet are the grounding point. The size of the skin bum is usually circumscribed, but the wound is often deep, involving with progressive severity subcutaneous tissue, nerve, muscle and bone {iceberg lesion) . Surgical treatment must be performed as soon as possible, as well as resuscitation therapy and management of systemic complications. Escharotomy and fasciotomy must be performed in case of circumferential injuries and/or in presence of compartment syndrome. Debridement of non-viable tissues must be performed early but avoiding sacrifice of tissues of questionable viability until complete demarcation of necrotic areas occurs. To protect the wound bed and the vital structures eventually present, appropriate skin substitutes are required. Finally reconstruction of the injured areas must beplanned focusing attention on restoring complete function of the extremities involved [3-5].