Early and late term microsurgical free flap reconstruction and risks in high voltage electrical injury

Abstract

The aim of the study is to discuss and compare the early and late micro vascular flap reconstruction's outcomes, importance, risks, advantages and disadvantages with review of our 13 high voltage electrical burn injury cases. Medical records have been reviewed for electrical burns in last three years. 13 cases fitting the criterion were included into the study. Four of them have been hospitalized for late complication such as severe contracture; nine of them have been hospitalized for acute treatment. Five patients had latissimus dorsi muscle flap, three patients had parascapular flap, two patients had latissimus dorsi and scapula osteomusculocutaneous flap, two patients had rectus abdominis musculocutaneous flap, and one patient had parascapular and scapular flap. Early reconstruction applied group showed a significant difference regarding to flap failure rates. Electrical injuries are more complex than regular burn injuries related with heat, and the reconstruction of these cases also should be special. One of the most important factor for free flap viability in electrical injury cases is surgery timing. All of the complications were seen in the patients who had surgery at 12th and 19th days after the electrical injury. No complication has seen in the group of patients who had surgery on late term period. However microsurgical reconstruction should be considered to cover exposed bony tissues on the extremities in the short term period in order to prevent possible limb shortening procedures.