Microvascular reconstruction after electrical and deep thermal injury

Six cases are presented demonstrating uncomplicated primary healing following early microvascular reconstruction for complex electrical and deep thermal injuries. We advocate early preservation of eschar and the prevention of infection with the use of penetrating topical antibacterial agents, removal of the soft-tissue eschar when clinically indicated, and immediate coverage of the undebrided bone through the provision of well-vascularized tissue. Microvascular free tissue transfer should be considered as a primary method of reconstruction for complex electrical or thermal injury whenever clinically feasible. These reconstructive techniques offer an early, reliable means of definitive reconstruction, preserving function, providing uncomplicated healing, and promoting early rehabilitation.