Microsurgical Flaps in High-Voltage Electrical Burns: Experience at the Chilean National Burn Reference Center

Abstract

ABSTRACT

OBJECTIVES: Microsurgical flaps in high-voltage electrical burns are commonly used in response to a scarcity of remaining local tissues. Here, we share our experiences with microsurgical flaps in patients with high-voltage electrical burns at the National Burn Reference Center in Chile. MATERIALS AND METHODS: We conducted a descriptive retrospective study of patients with high-voltage electrical burns reconstructed with microsurgical flaps who were seen at our center between 2019 and 2021. Demographic and surgical data were obtained from clinical records. Preoperative studies were performed with computed tomography angiography and Doppler ultrasonography. Surgeries were performed by staff plastic surgeons, who used the same techniques and instruments. Postoperative monitoring was performed using conventional clinical methods. RESULTS: During the study period, 16 patients received a total of 19 flaps. Mean age was 41.5 years (range, 20-69 years). All were men with mean percentage of total body surface area of 11.8% (range, 1% to 45%). Mean days from burn to flap surgery was 40 days (range, 28-68 days). The most frequent defects to be covered were foot and forearm, the most used flap was the anterolateral thigh flap, and the mean surgical time was 7.36 hours (range, 4.5-10.83 h). Overall success of the flaps was 94.7%. Four patients had flap complications, with need for reoperation in 3 patients. Mean hospital stay was 53 days (range, 16-98 days). CONCLUSIONS: The use of microsurgical flaps in patients with electrical burn is a safe option for defects in different anatomic locations, considering an adequate debridement, the use of healthy receptor vessels, a trained microsurgical team, and adequate timing.