Retrospective Review of Free Anterolateral Thigh Flaps for Limb Salvage in Severely Injured High-Voltage Electrical Burn Patients

Background High-voltage electrical injuries usually cause extensive and devastating damages to the extremities. Timely and effective coverage of the wounds to maximally preserve the viable tissue is important for salvage and the ultimate functional outcome of the involved extremities. In this study, free anterolateral thigh flaps with a single-perforator pedicle were conducted to maximize tissue salvage and decrease late skeletal and neuromuscular complications of the involved extremities injured by high-voltage electricity. Methods From June 2012 to December 2015, 12 patients with high-voltage electrical injuries on the extremities were recruited. After primary or secondary debridement, free anterolateral thigh flaps with a single-perforator pedicle were used for limb salvage. Patients' clinical records, including etiology, sex, age, perforator type, defect location, duration before admission, defect and flap size, timing of reconstruction, and complications, were extracted and analyzed. Results All patients were followed up ranging from 10 to 25 months, with an average follow-up of 15.9 months. Free anterolateral thigh flap with a single-perforator pedicle was performed for 12 consecutive patients with high-voltage electrical injuries. The mean time taken before the transplantation of the flap was 5.25 days, with a range from 2 to 8 days. The average size of the resultant defects after debridement was 187.0 cm2 (84–350 cm2), the average size of the flaps was 265.3 cm2 (119–448 cm2), and the average time of the surgical operation was 314.6 minutes (260–355 minutes). All flaps healed uneventfully without associated complications. No weakness of the donor thigh was observed in all cases. Conclusions Free anterolateral thigh flaps with a single-perforator pedicle were an effective and reliable therapeutic intervention for the management of severe high-voltage electrical injuries on the extremities.

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