The use of free tissue transfer in burn reconstruction

Patients that sustain extensive burns commonly present the reconstructive surgeon with problems caused by exposed tendons, scar contractures, and loss of digits. Frequently there is inadequate local tissue available to solve these reconstructive problems. To solve these complex postburn defects, we have used free tissue transfer in addition to more traditional therapy. From 1987 thru 1994, we have used free tissue transfer as an adjunct to our reconstructive armamentarium in 35 patients who have undergone a total of 45 free tissue transfers for the correction of postburn deformities. There have been two failures (96% flap survival). There were 27 males and 9 females. Twelve free flaps were performed during the initial hospitalization, and 33 were performed during subsequent hospitalizations. Sites of reconstruction included the hand (n = 17), neck (n = 12), face (n = 8), leg (n = 4), penis (n = 2), arm and axilla, 1 each. Flap origin included anterolateral thigh (n = 16), parascapular (n = 10), digital transfer (n = 4), rectus abdominus (n = 3), radial forearm (n = 3), groin, fibula, and foot, two each. Nine flaps underwent prefabrication or prelamination before transfer. In summary, free tissue transfer is a valuable tool in burn reconstruction and it can be used safely and effectively with minimal morbidity to the patient.