The Use of Free Flap Transfers in Acute Burn Hand Injuries

Abstract

Free flap transfers can be used to reconstruct the complex tissue deficit resulting from a deep burn that exposes bones, tendons, or neurovascular structures which are unable to support a skin graft. Benefits of free flap transfers in the acute stage are early wound closure, early mobility, decreased hospital stay, and possible limb salvage. The purpose of this retrospective study is to describe a single center's experience in free flap transfers for acute burn hand injuries. Between March 1996 and February 2004, twenty-five patients with acute burn hand injuries, who were treated at the burn unit of Linkou Chang Gung Memorial Medical Hospital, were reviewed for free flap transfers. The following data was collected: age, gender, the etiology of burn injury, the percentage of the burned extent, flap type, operations before free flap coverage, timing of free flap coverage, operation time, length of hospital stay, complications and flap outcome. All twenty-five free flaps were fasciocutaneous flaps and all survived. Two flaps among them with partial necrosis required debridement and skin graft coverage because of wound infection. There was neither vascular compromise to the flap nor donor-site morbidity in any case. Free fasciocutaneous flap transfer in acute burn hand injury provides a safe, efficacious and one-stage functional reconstruction. Flap survival and complication rate are not influenced by the etiology of burn injury and the timing of free flap coverage. This approach may minimize donor-site morbidity, postoperative complications and length of hospital stay.