Loco-Regional Perforator Flaps for Reconstruction of Post Burn Contracted Elbow

Abstract

Context: the post-burn scar is inevitable problem even with the best treatment as it depends on the depth of the burn injury, so only superficial dermal burns, heal with no scarring, but the contracture is preventable problem especially with the best treatment. The post-burn elbow flexion contracture may be associated with heterotropic calcification of the elbow joint which needs orthopedic team consultation. The elbow reconstruction represents a demanding procedure for the plastic surgeon. Objective: aim of this study was to evaluate the validity and application of local arm forearm and regional chest perforator flaps for coverage after release of post burn elbow contractures. Patients and Methods: this prospective randomized study was done on 20 patients aged from 6 to 54 years old. All of them were asking for elective release of postburn flexion contracture of the elbow at outpatient clinics of Al Azhar University and Al-Ahrar Teaching Hospitals. It was done from March 2018 to March 2019. Results: we have performed in our study the local and regional perforator flaps as lateral arm flap, medial arm flap, PBUF flap, PBRF flap, thoracoabdominal pedicle flap. Skin grafting is an easy procedure, however, success is limited with the technique because there is always the risk of incomplete graft take and prolonged splinting and physiotherapy is imperative in the postoperative period. Conclusion: flaps are better for resurfacing the defects after post-burn contractures release. Flaps do not need vigorous post-operative physiotherapy or splint age and grow with age especially in children.