Use of previously burned skin as random cutaneous local flaps in pediatric burn reconstruction

Reconstruction after post-burn scarring remains a challenge. It is especially true in the severely burned patient, who normally presents with a paucity of donor sites. Healed skin from areas that had been burned and skin from grafted areas (termed as previously burned skin) have been occasionally used as flaps, but their safety is still in debate. We studied all patients undergoing burn reconstruction with normal skin flaps and previously burned skin flaps in the same operative procedure between April 1998 and October 1998 to determine the safety of flaps including burned and healed tissues. Patients served as their own controls. Three hundred and fifty-three local flaps were studied in 74 patients. These included 238 previously burned skin flaps and 115 normal skin flaps. There were no differences in complication rates between groups and only one previously burned skin flap suffered from complete necrosis. The use of local previously burned skin as flaps in burn reconstruction is safe. Reconstruction with flaps should be considered as first choice in burn reconstruction regardless of the quality of the local tissue.