In more than 70% of patients with severe burns, the hands or upper extremities are involved. In more than 58% of these cases both hands are involved [1,2]. The mechanism of trauma is variable (flame, scald, electric, chemical, contact) and in the case of electrical burn, there are several factors determining the severity: amperage, resistance of the body at the point of contact, type and magnitude of current, current pathway and the duration of the current flow [1,3]. In case of low-tension with a frequency of 50–60 Hz the current may cause convulsive contraction leading to muscle tetany, which does not allow the release of the involved hand from the current source, therefore, the duration of current flow and damage is greater. Low voltage (110–220 V) 60 Hz current may also induce ventricular fibrillation. Due to increased duration of electric current onto the skin and its underlying structures, the electrical injury has changed its main character into a thermal trauma due to the Joule effect. This is the one of the main causes of why low voltage injuries are comparable to thermal injuries [3]. In many cases electrical injuries to the hand produces devastating injuries involving deeper structures of the hand (tendons, joint capsules or bone), so often these kind of injuries require flaps or amputation. Secondary impairment from this injury is massive [1,3–9]. In order to preserve as much function as possible often local or free tissue transfers are necessary. These surgical procedures may lead to a considerable blood loss, which require blood transfusions. The rejection of blood transfusions may risk the outcome of the patients as well as the outcome of the free flap. Jehovah’s Witnesses do