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Updated: Aug 30, 2026
Structured Motor Rehabilitation After Selective Nerve Transfers
Published on: August 15, 2019
The use of free tissue transfers in acute thermal and electrical extremity injuries
Hedieh A Stefanacci1, Darl K Vandevender, Richard L Gamelli
1Department of Surgery, Loyola University Medical Center, Maywood, Illinois 60153, USA.
Background:
This article presents a retrospective analysis of a case series of patients requiring free tissue transfers for acute thermal and electrical injuries in a single burn center.
Methods:
Eight patients, in the period between 1997 and 2001, were referred for evaluation of extensive thermal injury to one or more extremities, which required free tissue transfer to achieve coverage. A total of 12 flaps were performed on eight patients. Data including flap type, flap viability, complications, hospital stays, length of rehabilitation, and time until return to work were collected.
Results:
Twelve flaps were performed on eight patients. One patient died. We report a flap failure rate of 9% (1 of 12) and two postoperative infections. Follow-up ranged from 3 months to 4 years. Flap types included lateral arm, radial forearm, rectus abdominis, posterior lateral thigh, and omentum and temporoparietal fascia. Mean hospital stay was 22 days, with a mean rehabilitation time of 9.7 months. Sixty-two percent of patients returned to work.
Conclusion:
Free tissue transfer is a safe and efficacious method of early surgical management of thermal and electrical burns. Electrical burns account for a disproportionate number of injuries requiring free tissue transfers. These injuries frequently necessitate the use of multiple free flaps. Postoperative complications and length of stay can be minimized by the use of split donor flaps during one operative session.
