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Early laparotomy and timely reconstruction for patients with abdominal electrical injury: Five Case Reports and Literature Review.

Abstract High-tension electricity can cause devastating injuries that may result in abdominal wall loss, visceral damage, and sometimes major threat to life. The visceral organ may be exposed after debridement and require flap cover, but the tensile strength of abdominal wall may be lack even if flap transplanted.
PMID
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Authors

Mayor MeshTerms

Laparotomy

Reconstructive Surgical Procedures

Keywords
Journal Title medicine
Publication Year Start




PMID- 28723751
OWN - NLM
STAT- MEDLINE
DA  - 20170720
DCOM- 20170728
LR  - 20170728
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 29
DP  - 2017 Jul
TI  - Early laparotomy and timely reconstruction for patients with abdominal electrical
      injury: Five Case Reports and Literature Review.
PG  - e7437
LID - 10.1097/MD.0000000000007437 [doi]
AB  - INTRODUCTION: High-tension electricity can cause devastating injuries that may
      result in abdominal wall loss, visceral damage, and sometimes major threat to
      life. The visceral organ may be exposed after debridement and require flap cover,
      but the tensile strength of abdominal wall may be lack even if flap transplanted.
      METHODS: From April 2007 through May 2015, 5 patients with severe abdominal
      electrical injury were treated at our hospital. Exploratory laparotomy was
      performed based on their clinical manifestations and debridement findings of
      abdominal wall at early stage, and decision regarding technique for
      reconstruction of abdominal wall was based on an assessment of the location and
      extent of the defect. Medical records were reviewed for these data. RESULTS:
      Clinical evaluation and debridement findings of the abdomen revealed 4 patients
      with suspicious visceral damage. Laparotomy was performed in 4 cases, and
      revealed obvious lesion in 3 cases, including segmental necrosis of small
      intestine, partial necrosis of diaphragm, left liver and gastric wall, and
      greater omentum. Five patients underwent abdominal wall reconstruction using
      island retrograde latissimus dorsi myocutaneous flap or free/island composite
      anterolateral thigh myocutaneous flap. All flaps survived, abdominal bulging
      occurred in 3 cases after follow-up of 12 to 36 months. CONCLUSIONS: The clinical
      manifestations and wound features of abdomen collectively suggest a possible
      requirement of laparotomy for severe abdominal electrical burns. Retrograde
      latissimus dorsi myocutaneous flap or composite anterolateral thigh myocutaneous 
      flap is an effective option for reconstruction of abdominal wall loss, the
      long-term complication of abdominal bulging, however, remains a significant
      clinical challenge.
FAU - Zhang, Pi-Hong
AU  - Zhang PH
AD  - aDepartment of Burns and Reconstructive Surgery bDepartment of General Surgery
      cInstitute of Burn Research, Xiangya Hospital, Central South University,
      Changsha, Hunan Province, P.R. China.
FAU - Liu, Zan
AU  - Liu Z
FAU - Ren, Li-Cheng
AU  - Ren LC
FAU - Zeng, Ji-Zhang
AU  - Zeng JZ
FAU - Huang, Geng-Wen
AU  - Huang GW
FAU - Xiao, Mu-Zhang
AU  - Xiao MZ
FAU - Zhou, Jie
AU  - Zhou J
FAU - Liang, Peng-Fei
AU  - Liang PF
FAU - Zhang, Ming-Hua
AU  - Zhang MH
FAU - Huang, Xiao-Yuan
AU  - Huang XY
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Abdominal Injuries/etiology/pathology/*surgery
MH  - Adult
MH  - Debridement
MH  - Electric Injuries/pathology/*surgery
MH  - Humans
MH  - *Laparotomy
MH  - Male
MH  - Middle Aged
MH  - *Reconstructive Surgical Procedures
MH  - Surgical Flaps/pathology
MH  - Time Factors
EDAT- 2017/07/21 06:00
MHDA- 2017/07/29 06:00
CRDT- 2017/07/21 06:00
AID - 10.1097/MD.0000000000007437 [doi]
AID - 00005792-201707210-00016 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Jul;96(29):e7437. doi: 10.1097/MD.0000000000007437.