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KMID : 0853020120150010049
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Journal of Korean Burn Society
2012 Volume.15 No. 1 p.49 ~ p.54
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Coverage of Electrically Burned Upper Extremity Amputation Stumps by a Pedicled Latissimus Dorsi Flap
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Kwon Do-Hyun
Ko Jang-Hyu
Hur Gi-Yeun
Seo Dong-Kook
Lee Jong-Wook
Choi Jai-Koo
Jang Young-Chul
Ryu Kang-Seok
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Abstract
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Purpose: In cases of high voltage electrical burns, a wound occurs as current enters or leaves the body and is accompanied by deep tissue injury. If upper extremity amputation is inevitable, consideration should be given to the residual limb functions, secondary reconstruction, and wearing of an upper prosthesis. Our hospital has achieved satisfactory outcomes through the use of a pedicled latissimus dorsi (LD) flap in patients undergoing transhumeral amputation and shoulder disarticulation due to upper extremity damage from high voltage electrical burns.
Methods: The study was targeted to five patients who suffered high voltage electrical burns, underwent above-elbow amputation, and were reconstructed in the acute and secondary phases using a pedicled LD flap from January 2005 to December 2011. All patients underwent equilateral pedicled LD flap surgery, with primary closure at the donating site.
Results: The average age of patients was 49.6 years (38∼ 64); they were all male. One patient underwent sublayer skin grafting after a pedicled muscular LD flap, and four patients had a pedicled myocutaneous LD flap: one patient among the four had a forearm flap after the pedicled myocutaneous LD flap. All flaps were well adhered, and post-surgical flap reduction and local flaps were performed for adequate sizing and aesthetic improvement.
Conclusion: In cases of upper arm amputation due to wide upper extremity damage caused by electrical burns, the use of the pedicled LD flap and adequate amputation length made subsequent wearing of a prosthesis possible. The pedicled LD flap procedure allowed reconstruction of a relatively large area of soft tissue and the surgery to the donating site was unproblematic. (J Korean Burn Soc 2012;15:49-54)
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KEYWORD
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Amputation, Pedicled LD flap
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