Treatment of electrical burns by single debridement followed by free-flap coverage: How important is timing?

High-voltage electrical burns involving the extremities may cause marked loss of skin and subcutaneous tissue exposing underlying bone and tendon. Treatment of electrical burns has historically involved serial debridement with late wound closure. Success has been reported with the use of microvascular free-flap transfer within three days of injury.

Seven patients with severe high-voltage electrical burns are presented. The application and timing of microvascular free-flap coverage is discussed.

Six of the seven patients achieved successful healing with the free flaps.

Delay of microvascular free-flap coverage beyond the previously published three-day protocol may not dramatically affect treatment success.