Use of the Lateral Intercostal Perforator-Based Pedicled Abdominal Flap for Upper-Limb Wounds From Severe Electrical Injury

Abstract

Background: 

Upper-extremity wounds can be covered with a variety of flaps. However, pedicled distant flaps still have a place in treatment, especially in the early stages of wound restoration after a severe electrical injury. The purpose of this clinical study was to present the use of the pedicled abdominal flap, using the blood supply of the lateral intercostal perforator vessel, to cover defects caused by severe electrical injury.

Methods: 

Between 2003 and 2005, 6 cases of deep burn wounds were treated with a lateral intercostal perforator-based pedicled abdominal cutaneous flap, with the blood supply originating from the lateral perforator branches of the seventh to 10th intercostal arteries. This flap was used to repair deep burn wounds on the elbow, forearms, and hands that were the result of severe electrical injuries.

Results: 

Flaps were harvested in sizes ranging from 16 cm × 12 cm to 9 cm × 7 cm. The pedicle was separated from 18 to 21 days after the operation. Five flaps survived entirely. The sixth underwent marginal necrosis (1.5 cm × 3 cm) at the distal portion of the flap because flap cutting exceeded the paraumbilical line. Results were cosmetically satisfactory for all patients.

Conclusions: 

This flap is suitable for covering defects in hands, forearms, and elbows. The procedure was performed easily, safely, and reliably, and the flap has several advantages over other commonly used techniques for upper-limb wounds from severe electrical injury. We recommend this flap as the treatment of choice.

In Brief

Six deep electrical injuries of the upper extremity were satisfactorily reconstructed with lateral intercostal perforator-based pedicled abdominal flaps. The flaps were easily and quickly raised and were reliable if the paraumbilical line was not exceeded.