Bilateral Pedicled Superficial Epigastric Flap in the Management of Circumferential Combined Degloving and Full Thickness Burn Hand Injury—A Case Report英文文献资料.docVIP

Modern Plastic Surgery, 2012, 2, 35-38 35 /10.4236/mps.2012.22009 Published Online April 2012 (http://www.SciRP.org/journal/mps) Bilateral Pedicled Superficial Epigastric Flap in the Management of Circumferential Combined Degloving and Full Thickness Burn Hand Injury—A Case Report Medhat E. Habib, Christoph H. Reuter Department of Plastic, Reconstructive and Craniofacial Surgery, Mafraq Hospital, Abu Dhabi, UAE. Email: medhatemil1@ Received February 10 , 2012; revised March 9 , 2012; accepted April 3 , 2012 th th rd ABSTRACT We report a case of combined hand trauma in the form of circumferential degloving injury of the hand with full thick- ness friction burns of the hand, forearm and the distal part of the upper arm. On exploration the hand was found avas- cular with loss of vital structures and full thickness burns. As a salvage procedure the hand was embedded in the subcu- taneous tissue of the abdomen for 4 weeks and after that elevated as an inferiorly based flap on the bilateral superficial inferior epigastric arteries. Two weeks later the hand was freed by division of the base of the flap bilaterally. The details and description of the injury, the procedure and the outcome are discussed. Keywords: Hand Burn; Mutilating Degloving Injury; Superficial Inferior Epigastric Artery Flap 1. Introduction partially lost and wrinkled distally in a degloving way with loss of tissue of the wrist and distal forearm (Figure 2). The soft tissues of the hand were crushed and burned. At the palmar surface, the flexor tendons were partially cut with loss of lumbrical, thenar and hypothenar mus- cles. The vessels were avulsed and coagulated distal to the deep palmar arch including the metacarpal and com- mon digital arteries. The branches of the median nerve were exposed (Figure 3). At the back of the hand the exten