Free Flaps in the Treatment of Burns

Introduction: Applying of the free flaps in the treatment of the patients with burn could be in the phase of covering of the burn wounds, or in the phase of correction of the postburned sequelas. We operated eight patients with burns by using free flaps in Military Medical Academy.

The treatment of the deep burn wounds implies excision and skin grafting. The burned surfaces where there are exposed vital structure should be covered with skin flaps.

Methodology and Material: In eight burned patients (one with deep facial burn, four with lower leg burns with exposed bones and one with deep electrical burns of the both forearms) it was impossible to cover those defects neither with skin grafts nor with local flaps due to tissue destruction. The tissue defects were covered by using microvascular flaps as a delayed or secondary procedure. For the defect of the whole half of the face we used free scapular flap, and for the lower leg defects we used latissimus dorsi musculocutaneous flaps in three cases and free scapular flap in one case.

Results: For the defects on forearm we applied latissimus dorsi flap and a week later scapular flap on the other forearm. In two patients with burns of the face and neck we applied scapular and parascapular flaps. We covered the remaining exposed mandibular bone in one patient. After four correction of the contracture of the neck with skin graft, in second patient we applied preexpanded scapular and parascapular flap and obtain permanent correction of the neck’s contarcture.

Conclusions: Our experiences in the treatment of those burned patients indicated the possibility of applying the free flaps in the early phase of the covering of the exposed deep structures, and in later reconstructive phase for corrections of postburned sequelas also.