Browse > Article

Study of Loss of Free Flap and Safer Timing of the Operation in Electrical Injury  

Chung, Eui Young (Department of Plastic and Reconstructive Surgery, Hangang Sacred Heart Hospital, College of Medicine, Hallym University)
Lee, Jong Wook (Department of Plastic and Reconstructive Surgery, Hangang Sacred Heart Hospital, College of Medicine, Hallym University)
Koh, Jang Hue (Department of Plastic and Reconstructive Surgery, Hangang Sacred Heart Hospital, College of Medicine, Hallym University)
Seo, Dong Kuk (Department of Plastic and Reconstructive Surgery, Hangang Sacred Heart Hospital, College of Medicine, Hallym University)
Chung, Chan Min (Department of Plastic and Reconstructive Surgery, Hangang Sacred Heart Hospital, College of Medicine, Hallym University)
Jang, Young Chul (Department of Plastic and Reconstructive Surgery, Hangang Sacred Heart Hospital, College of Medicine, Hallym University)
Oh, Suk Joon (Department of Plastic and Reconstructive Surgery, Hangang Sacred Heart Hospital, College of Medicine, Hallym University)
Publication Information
Archives of Plastic Surgery / v.32, no.5, 2005 , pp. 567-572 More about this Journal
Abstract
An electrical burn used to result in the damage of the skin and underlying deep soft tissue injury. Thus, in order to preserve devitalizing tissues and promote the structural survival free flaps with ample blood supply are frequently employed. However, early unpredictable vascular injury and progressive tissue necrosis may cause the free flaps full of hazards. We applied 50 free flaps upon 41 acute electrical burn cases between 1998 and 2004. Injured areas, timing of operation and causes of flap loss were studied. The victim's ages ranged from 13 to 60 years. (an average 37.8 years) Thirteen out of 50 free flaps were lost totally: three cases were due to arterial insufficiency and ten venous congestion. Total loss of flaps were observed in 5 of 12 cases in the postoperative 3 weeks, 6 of 20 cases between 3 and 6 weeks and 2 of 18 cases after 6 weeks. In three of 12 cases the free flap was lost partially in the postoperative 3 weeks, 4 of 20 cases between 3 and 6 weeks and 1 of 18 cases after 6 weeks. The result was statistically significant by a T-test (p<0.05). This study showed that timing of the operation is accountable for the loss of free flap. It is most important to conduct the free flap procedure on an electrical injury at the time when the recipient vessel is definitely discernible and intact so as to minimize the loss of flap and spare the structures.
Keywords
Electrical burn; Flap loss; Operation timing;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Robson Me, Murphy RC, Heggers JP: A new explanation for the progressive tissue loss in electrical injuries. Plast Reconstr Surg 73: 431, 1984   DOI   ScienceOn
2 Boeckx W, Lorenzi F, Hulst R: Free flaps in bum reconstruction. Burns 27: 603, 2001   DOI   ScienceOn
3 Shen T, Sun Y, Cao D, Wang N: The use of free flap in burn patients: experiences with 70 flaps in 65 patients. Plast Reconstr Surg 81: 352, 1998
4 Baumeister S, Koller M, Dragu A, Germann G, Sauerbier M: Principles of microvascular reconstruction in burns and electrical bum injuries. Burns 31: 92, 2005   DOI   ScienceOn
5 Silverberg B, Banis JC, Verdi GD, Acland RD: Microvascular reconstruction after electrical and deep thermal injury. J Trauma 26: 128, 1986   DOI
6 Chick LR, Lister GD, Sowder L: Early free flap coverage of electrical and thermal burns. Plast Reconstr Surg 89: 1013, 1992   DOI   ScienceOn
7 Hunt JL, McManus WF, Haney WP, Pruitt BA: Vascular lesions in acute electric injuries. J Trauma 14: 461, 1974   DOI
8 Ponten B, Erikson U, Johansson SH, Olding L: New observation on tissue changes along the pathway of the current in an electrical injury: case report. Scand J Plast Reconstr Surg 4: 75, 1970   DOI
9 Daniel RK, Ballard PA, Heroux P, Zelt RG, Howard CR: High-voltage electrical injury; Acute pathophysiology. J Hand Surg 13A: 44, 1988
10 Zhu Z, Xu X, Li W, Wang D, Zhang L, Chen L, Liu T: Experience of 14 years of emergency reconstruction of electrical injuries. Burns 29: 65, 2003   DOI   ScienceOn
11 Platt AJ, McKiernan MV, Mclean NR: Free tissue transfer in the management of burns. Burns 22: 474, 1996   DOI   ScienceOn
12 Hagan KF, Buncke HJ, Gonzalez R: Free latissimus dorsi muscle flap coverage of and electrical burn of the lower extremity. Plast Reconstr Surg 69: 125, 1982   DOI   ScienceOn
13 Buchanan DL, Erk Y, Spira M: Electrical current arterial injury: A laboratory model. Plast Reconstr Surg 72: 199, 1983   DOI   ScienceOn
14 Zelt RG, Daniel RK, Ballard PA, Brissette Y, Heroux P: High-voltage electrical injury: chronic wound evolution. Plast Reconstr Surg 82: 1027, 1988   DOI   ScienceOn
15 Guo Z, Sheng Z, Li F: Wound management in electrical injuries. Ann N Y Acad Sci 30: 105, 1999