Abstract
Microsurgical free flap reconstruction in acute burn care offers the option of reconstructing even challenging defects in a single stage procedure. Due to altered rheological and hemodynamic conditions in severely burned patients, it bears the risk of a higher complication rate compared to microsurgical reconstruction in other patients. To avoid failure, appropriate indications for free flap reconstruction should be reviewed thoroughly. Several aspects concerning timing of the procedure, individual flap choice, selection and preparation of the recipient vessels, and perioperative measures must be considered. Respecting these specific conditions, a low complication rate, comparable to those seen in microsurgical reconstruction of other traumatic limb defects, can be observed. Hence, the free flap procedure in acute burn care is a relatively safe and reliable tool in the armamentarium of acute burn surgery. In reconstructive burn care, microsurgical tissue transfer is routinely used to treat scar contractures. Due to the more robust perioperative condition of patients, even lower rates of complication are seen in microsurgical reconstruction.
Highlights
Received: 6 June 2021Accepted: 13 July 2021Published: 16 July 2021Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.Soft tissue reconstruction by microsurgical free flap reconstruction is a rarely required, but eminent, surgical tool in acute burn care
Using free rectus abdominis (Pennington, 1980 [23]), vastus lateralis (Ger, 1976 [24]) or latissimus dorsi muscle flaps (Tansini, 1896 [25]) combined with split-thickness skin grafts (STSG), large-scale defects can be closed in a single-stage procedure and may be especially required in acute burn reconstruction
Microvascular reconstruction in primary burn reconstruction might have a slightly higher risk compared to free flap reconstruction in general, but from our perspective, these risks and further relative disadvantages like operating time, the need for prompt complication management, and potential donor site defects, are counterbalanced by the numerous advantages—especially the preservation of a significantly injured extremity
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Soft tissue reconstruction by microsurgical free flap reconstruction is a rarely required, but eminent, surgical tool in acute burn care. Due to substantial differences in indication, technique, and outcome, free flap reconstruction in acute burn care and in burn reconstruction must be considered separately. Free flaps for both indications have been described only a very few years after Cobbett’s historical first microsurgical tissue transfer [1]. In 1975 when Sharzer et al [2] presented the successful transfer of two free groin flaps for acute burn wound reconstruction, and when Harii et al [3] reported. 47 free flap procedures for secondary reconstruction of 36 contractured or unstable burn scars in the same year
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
