[Repair of occipital and nuchal wounds with inferior trapezius myocutaneous flaps in patients after high voltage electrical burn].
OBJECTIVE
To explore the methods and effects of repair of occipital and nuchal wounds with inferior trapezius myocutaneous flap after deep electrical bum.


METHODS
Twelve patients with high-voltage electrical burn in occipital and nuchal regions were hospitalized to our ward from March 2003 to September 2007. They were repaired with improved inferior trapezius myocutaneous flaps after debridement. Flaps were of two types: (1) blood supply from cutaneous and perforator branches of the original segment of the superficial descending branch of transverse cervical artery. (2) combined blood supply from both superficial and deep descending branches of transverse cervical artery C, i.e., dorsal scapular artery). All flaps carried segmental and limited trapezius muscle cuff surrounding the vascular pedicle of the flap similar to a perforator flap.


RESULTS
Flaps survived completely primarily in eight cases. In two patients, infection developed in flaps adjacent to wounds with lignification; they healed after dress change. Necrosis appeared in distal end of flap (one case), it healed after re-operation. One patient with surviving flaps died of sepsis and multiple organ failure 21 days after operation. The flaps which survived were not swollen ; the donor sites at scapular region looked normal without pterygoid or pendulous scapula deformities.


CONCLUSIONS
Inferior trapezius myocutaneous flaps can be used to repair occipital and nuchal wounds, with the advantages of constant blood vessels, reliable blood supply, convenience for application.
Zhu
Jing-min
JM
Department of Burns and Plastic Surgery, General Hospital of Beijing Army of PLA, Beijing 100026, PR China.
Hao
Tian-zhi
TZ
Sun
Zhi-gang
ZG
He
Li-xin
LX
Cao
Yu-jue
YJ
Lu
Gang
G
D000328:Adult; D002058:Burns, Electric / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000637:transplantation*; D019838:Neck Injuries / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods; D013524:Surgical Flaps