Summary
Background
Microvascular reconstruction is rarely indicated in burn injuries. As the versatility
and variability of free flaps have increased significantly during recent years so,
the indications for this procedure have been expanded for limb salvage after electrical
injuries.
Methods
We report retrospectively the results of 26 free flaps for extremity reconstruction
in 19 patients suffering from severe electrical burn injuries. Nine different free
flap types were used. On the basis of this experience we were able to establish reconstructive
principles in electrical injuries pertinent to the timing of reconstruction procedures.
Results
Early coverage with muscular flaps was the most frequently used type of reconstruction.
At a later stage of the treatment course reconstruction with cutaneous or fascial
flaps was the preferred method; for the reconstruction of complex or multistructural
defects (n=3) combined ‘chimeric’ flaps were used.
Overall, the flap failure rate was 15% (n=4). Interestingly, there was a relationship between flap failure rate and timing of
the procedure. All the flap failures occurred within 5–21 days after trauma. No flap
failure occurred during secondary reconstruction.
Conclusions
Our data demonstrate that electrical burn injuries are distinct entities requiring
individual reconstructive solutions for limb salvage. Even if our flap failure rate
is relatively high it should not be forgotten that this type of reconstruction represents
an opportunity for limb salvage as opposed to early amputation.
Keywords
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Article info
Publication history
Published online: May 10, 2007
Accepted:
December 27,
2006
Received:
August 17,
2006
Identification
Copyright
© 2007 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
