Versatility of a Pedicled Reverse-flow Lateral Arm Flap and a Radial Collateral Artery Perforator-based Propeller Flap in the Treatment of Post-high-voltage Electrical Injury Around the Elbow Region

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  • Kikuchi Noriaki
    Department of Plastic and Reconstructive Surgery, Okitama Public General Hospital
  • Yano Akiko
    Division of Plastic and Reconstructive Surgery, Yamagata University Hospital

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  • 肘関節周囲の電撃傷に対する逆行性外側上腕皮弁と穿通枝プロペラ皮弁による治療経験

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Abstract

 Electrical injuries can be divided into low-voltage and high-voltage ones, that is, below or above 1,000 V, respectively. Two cases of electrical injury caused by exposure to high-voltage alternating current are reported.<br>  Case 1: A 15-year-old boy trespassed and climbed up the train inspection stand. He swung his right leg forward, near the overhead tension wire (20,000 V) , and sustained an electrical injury from his right toe into the right hand from grasping the safety bar, before falling to the ground. Compartment syndrome, which required incisional decompression, developed in the right forearm and lower leg. Following primary treatment, the antecubital contracture was released with a pedicled reverse-flow lateral arm flap（reverse-flow LAF）.<br>  Case 2: A 78-year-old male in the transformer station during an occupational inspection accidentally came into contact with the tension wire（3,810 V）with his left elbow. A deep skin ulcer around the olecranon was covered with a radial collateral artery perforator（RCAP）-based propeller flap.<br>  The island flap of the reverse-flow LAF revealed congestion from during the operation. The operative time using the RCAP-based propeller flap was shorter, used a continuous skin paddle, and congestive change was not found. Both cases achieved effective results and functional improvement.<br>

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