The use of free flaps in burn patients: experiences with 70 flaps in 65 patients

A series of 70 microvascular free flaps employed in 65 burn patients is presented. The total survival incidence of the flaps was 87 percent. Satisfactory wound healing was achieved in 80 percent of a total of 54 flaps in fresh burn patients. In the 16 patients with healed burns, flap survival was 100 percent with satisfactory functional and cosmetic results. The cruxes of dealing with difficult fourth-degree burns by using microvascular free flaps and our special considerations about the indications and overall morbidities of the donor site are discussed. This large-series report confirms other occasional reports on the use of free flaps in burn patients. It is our belief that the microvascular free flap is the most expeditious means of dealing with refractory burn wounds, even when more conventional techniques are available. In certain cases, the microvascular procedure is the only method that can salvage an extremity.