The early use of free flaps in burns

Fourth degree burns of the extremities, that is, burn wounds that go down to denuded bone or tendon, frequently necessitate either amputation of the involved limb or multistage reconstructive procedures involving prolonged hospitalization so that the limb may be salvaged. It is our belief that in these patients free flaps should be considered as a means of initial wound closure. Microvascular procedures under these circumstances may well represent the most expeditious means of salvaging an extremity even when more conventional techniques are available. Studies of a series of patients illustrating this point are presented.