An alternative method to free flap for distal leg and foot defects due to electrical burn injury: distally based cross-leg sural flap.

Abstract

High voltage electrical injuries can cause devastating results especially in distal extremities. Although free flaps are the golden standards for the reconstruction of these defects, sometimes local flap alternatives are more useful. One of the most favorable local flap is distally based sural flap (DBSF), which can be used in cross-leg fashion when ipsilateral extremity is affected by a high voltage electrical injury. The purpose of this study was to evaluate long term results of eleven patients who underwent a reconstruction to the lower extremity with cross-leg DBSF due to high voltage electrical burn injury between the years of 2003-2013. Eleven patients suffering from high voltage electrical injury from 2003 to 2013 were evaluated retrospectively. All patients were male and had deep 2nd and 3rd degree electrical burns on many parts of their bodies, including their lower legs and feet. Seven of the defects were located on the right limb and four of them on the left. Defects were located in the ankle area in five patients, dorsum of the foot in four patients, achilles area in one patient, and the plantar region in one patient. The adaptation of flaps to the recipient site, colour, and quality were all acceptable. As an alternative to free flaps, the cross-leg DBSF has good tissue compliance, provides tissue of adequate quantity and quality, and has low complication rates in the long term in high voltage electrical injuries of the leg and foot.