title: Flow-through anterolateral thigh flap for reconstruction in electrical burns of the severely damaged upper extremity.
abstract: BACKGROUND
  Many surgeons have to face the challenge of the sophisticated management of catastrophic high-voltage injuries to upper extremities. These patients present with both vast soft tissue defects and varied segmental main artery defects with compromised circulation of the distal limb. This study is a first attempt to analyze the outcome of the flow-through anterolateral thigh flap for reconstruction in acute electrical burns of the severely traumatized upper extremity.
  
  
  METHODS
  From March 2001 to February 2012, five men were enrolled in the study. All in this series suffered from high voltage current (higher than 1000 V) electrical burn and had the presence of wide segmental soft tissue defects, exposure of underlying vital structures and segmental artery injury with compromised circulation. Flow-through anterolateral thigh flaps were used for limb salvage.
  
  
  RESULTS
  Follow up for all patients was present from 6 months to 7 years. The mean age was 37.8 years old. The mean timing of free flap transfer was 5.8 days after injury. The mean flap sizes were 31.6 cm × 16.5 cm. The mean artery defect was 14.2 cm in length. Venous thrombosis occurred 1 day post-operatively in one patient. No donor site morbidity was noted. In the postoperative period, no infection, no hematoma, nor deaths were noted. Successful limb salvage rate was 80% in this series.
  
  
  CONCLUSIONS
  In electrical injuries of the severely damaged upper extremity, flow through anterolateral thigh flaps provide for reconstruction of both the vessels and soft tissue simultaneously. Although the risk of flap failure is higher than with other etiologies of burn, the data shows that the above reconstruction technique is useful for upper extremity salvage.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taipei, Taiwan.
authors.forename: Yen-Chang
authors.initials: YC
authors.lastname: Hsiao
authors.forename: Jui-Yung
authors.initials: JY
authors.lastname: Yang
authors.forename: Cheng-Jen
authors.initials: CJ
authors.lastname: Chang
authors.forename: Chih-Hung
authors.initials: CH
authors.lastname: Lin
authors.forename: Shu-Yin
authors.initials: SY
authors.lastname: Chang
authors.forename: Shiow-Shuh
authors.initials: SS
authors.lastname: Chuang
mesh_terms: D000328:Adult; D002058:Burns, Electric / Q000601:surgery*; D058752:Free Tissue Flaps / Q000098:blood supply*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012039:Regional Blood Flow; D017695:Soft Tissue Injuries / Q000601:surgery; D013848:Thigh; D016896:Treatment Outcome; D034941:Upper Extremity / Q000098:blood supply / Q000293:injuries* / Q000601:surgery