Early Application of Microsurgical Flaps in the Electric Burns of Extremities: A Two Institutional Case Series

Abstract

Some groups have avoided early microsurgical flaps in electrical burns under the pretext of injury to the microvasculature, which could increase vascular thrombosis. However, this option frequently results in amputation of the extremity. This study aims to evaluate the early application of microsurgical flaps for the treatment of electrical burns of extremities. A case series was retrospectively evaluated including patients with electrical trauma in extremities undergoing early microsurgical reconstruction. Data were obtained from medical charts, including age, trauma location, flap type and microvascular anastomosis, the need for other procedures, postoperative complications, the length of hospital stay after the flap surgery, and patient outcomes. Five microsurgical flaps were performed in less than 30 days to trauma, one anterolateral thigh flap to cover skin failure in upper limb, and four radial forearm flaps to cover failure in feet. The patient ages had a mean of 25.8 years (from 12 to 42 years). The microsurgical procedure occurred from 21 to 27 days after the burn, with a mean of 24.2 days. Hospital discharge had a mean of 26.6 days (from 19 to 35 days after the surgery). Only one patient required reintervention for re-anastomosis. All patients had a good flap viability, avoiding amputation of the affected extremity and with a proper preservation of function. The early application of microsurgical flaps for patients with electrical burns of extremities may provide adequate, sturdy, and stable skin coverage, contributing to the treatment of noble structures exposed and avoiding amputation of the extremities.

Free Flap Failure and Complications in Acute Burns: A Systematic Review and Meta-analysis

“…After applying inclusion and exclusion criteria, 31 articles were included in the qualitative and quantitative synthesis. 8–10,18–46 A flow chart of the study inclusion process and the reasons justifying the exclusion of the 166 studies are shown in Figure 1.…”

Microsurgery in Burns

“…In the well-selected patient, it allows one-stage reconstruction of complex defects with optimal functional and cosmetic results and low morbidity. Despite the reported higher rate of complications compared to other clinical scenarios, free flaps may reduce the number of surgical procedures required to achieve wound closure and, in selected cases, represent an opportunity for limb salvage [11,12].…”

Colgajo libre paraescapular en la cobertura de quemaduras eléctricas. Reporte de caso

“…Las quemaduras eléctricas ocasionan un extenso daño en los tejidos blandos al alterar la macro y microvasculatura local. Los primeros informes sobre el uso de colgajos microquirúrgicos en pacientes con quemaduras, según Castro et al 1 , datan de la segunda mitad de la década de 1970. Sin embargo, tal como lo evidenciaron Grotting et al 2 , el primer caso de colgajo libre utilizado para la cobertura de una quemadura eléctrica aguda fue descrito en 1982; en dicha ocasión, al paciente se le realizó un injerto con un colgajo libre de dorsal ancho más injerto de piel de espesor parcial.…”