Abstract: Objective To explore the effects of pedicled axial flaps in repairing high-voltage electrical burns of the wrist and hand， and to summarize the flap selection strategy. Methods A retrospective study was conducted. From January 2018 to December 2023， 12 patients with high-voltage electrical burns of the wrist and hand were treated. All patients were male， aged from 31 to 55 years. A total of 13 wounds were found on the fingers （8）， back of the hand （1） and wrists （4）， with exposure of bone， tendon or joint cavities associated with the traumas， except in the palm. The Allen test， colour Doppler ultrasound， CTA or DSA were used to observe the condition of the vascular network of the wrist and hand. The appropriate pedicled axial flaps was selected to repair the wound based on location， area and vascularity. The donor area was repaired with skin grafts. Microcirculation perfusion and other treatments were performed postoperatively. After 6-24 months of followup， the appearance and function of the wrist and hand were evaluated. Results In this series of cases， the pedicled axial flaps included paraumbilical perforator flaps（ 3）， reverse flow ulnar artery island flaps（ 1）， forearm dorso-ulnar flaps（ 1）， reverse homodigital dorsal ulnar flaps of the thumb（ 1）， digital artery flaps（ 5）， and retrograde flow digital artery flaps（ 2）. All flaps survived， presenting a relatively satisfactory appearance. At final follow-up， wrist and hand function scores ranged from 45 to 90， 2 cases were rated excellent， 6 were rated good， 3 were rated acceptable and 2 were rated poor. Conclusion  For wrist and hand electrocution wounds， selecting appropriate pedicled axial flaps for wound repair based on the location， area and vascularity can achieve good results.

Key words: Electrical injuries, &emsp, Wrist, &emsp, Hand, &emsp, Flaps