The use of adipofascial turnover flaps for coverage of complex dorsal ring finger defects caused by electric burns

This paper describes a unique occupational electrical injury that results in a complex defect on the dorsal aspect of the ring finger. The injury was seen in seven electricians working while wearing a ring on the ring finger. All patients were treated successfully using random adipofascial turnover flaps. The electric current was found to cause a zone of subcutaneous necrosis adjacent to the skin burn. This zone of subcutaneous necrosis varied in size but never exceeded 5mm and it was easy to recognize the extent of this zone intraoperatively because of the presence of the thrombosed dorsal subcutaneous veins within the necrotic subcutaneous tissue. These observations suggested that adequate debridement and then location of the base of the adipofascial flap proximal to the edge of the debrided area was an appropriate procedure. Other technical considerations were described to ensure a successful outcome. It was concluded that adipofascial turnover flaps were not only reliable in these electrical injuries, but also had several advantages when compared with other flaps commonly used to reconstruct dorsal digital defects.