Thirty-eight free fasciocutaneous flap transfers in acute burned-hand injuries

The benefits of free flap transfers in the acute burn injury are early wound closure, early mobility, reduced hospitalization, and possibly limb salvage. This retrospective study will attempt to provide principles to the use of free fasciocutaneous flap for the reconstruction of acute burned-hand injuries. Between 1995 and 2004, 5521 patients were admitted to the burn unit at Linkou Chang Gung Memorial Hospital. Of these, 38 patients (0.7%) patients received free fasciocutaneous flap transfers. Each patient's chart was reviewed the following data: age, gender, burn injury type, percentage of the burned area to total body surface area, flap type, operations prior to free flap coverage, the size and location of recipient area, timing of free flap coverage, operative time, duration of hospital stay, complications, flap survival and returning to work. All 38 free flaps survived and healed well. Three flaps with partial necrosis due to wound infections required subsequent debridement and skin grafting. Arterial thrombosis occurred in one patient and was salvaged successfully. Minimal donor-site morbidity with no intraoperative mortality was observed. Free fasciocutaneous flap transfer is a safe, efficacious one-stage reconstruction for acute burned-hands with satisfactory aesthetic and functional outcomes. Flap survival is not affected neither by the etiologies of burn nor the timing of free flap coverage.