[The need for flaps in burn surgery]

Area of Science:

• Reconstructive surgery
• Burn management
• Tissue engineering

Context:

• Increasing survival rates in severe burn injuries necessitate focus on quality of life.
• Exposed vital structures after debridement require advanced tissue coverage beyond split skin grafts.
• Flap coverage is essential for preserving function and limb salvage in burn patients.

Purpose:

• To analyze the indications and outcomes of flap coverage in burn surgery.
• To provide detailed information on the necessity of flap use in burn reconstruction.
• To evaluate flap types, indications, and complication rates in a burn center cohort.

Summary:

• A retrospective analysis of 53 flaps in 45 burn patients (1997-2008) revealed flame burns as the most common cause.
• Flap coverage was predominantly used for primary reconstruction, particularly for upper extremities (53%), including hands (36%).
• Three total flap failures occurred, with two during the critical 6-21 day post-trauma period, highlighting the importance of timing.

Impact:

• Limb salvage was the primary indication for primary reconstruction, while function and aesthetics drove secondary reconstruction.
• Reconstruction timing significantly influences flap outcomes; the 6-21 day period should be avoided if possible.
• This study underscores the critical role of flap coverage in achieving good functional and aesthetic outcomes in burn survivors.