Free tissue transfer for burns reconstruction: A single-site experience

Area of Science:

• Plastic Surgery
• Burn Management
• Reconstructive Surgery

Background:

• Burn injuries present complex challenges for wound healing and scar management.
• Free tissue transfer (FTT) is a reconstructive option for severe burns.
• Long-term outcomes of FTT in burn care require further investigation.

Purpose of the Study:

• To review the efficacy of free tissue transfer (FTT) in managing acute burn wounds and reconstructive scar issues.
• To analyze the outcomes of FTT procedures performed at a UK burns unit over a decade.
• To describe specific techniques for FTT in challenging cases, such as neck contractures.

Main Methods:

• Retrospective review of 46 FTT procedures in 38 burn patients over 10 years.
• Analysis of flap success rates for primary wound coverage versus secondary scar reconstruction.
• Detailed description of anterolateral thigh and parascapular flap utilization, including pre-expansion techniques.

Main Results:

• Overall FTT success rate was high, with 100% success in acute interventions and one failure in scar reconstruction.
• Anterolateral thigh flaps were most common (57%), followed by parascapular flaps (22%).
• Hypertrophic scarring occurred at the flap interface in 17% of cases.

Conclusions:

• Free tissue transfer (FTT) is a successful and viable surgical solution for both acute burn wound coverage and scar contracture revision.
• Specific techniques, like pre-expanded parascapular flaps anchored to pre-tracheal fascia, offer good contouring for neck contractures.
• Further research into preventing hypertrophic scarring at flap interfaces is warranted, and a consensus protocol for FTT in primary burn management is recommended.