title: Elbow reconstruction using island flap for burn patients.
abstract: BACKGROUND
  Deep burns of the elbow lead to soft tissue necrosis and infection, with exposure of deep structures. Adequate wound coverage of this area requires thin, pliable, and durable tissue, while optimal functional recovery requires early coverage and functional rehabilitation. We have found 3 types of island flaps that provide reliable coverage for the elbow.
  
  
  METHODS
  A retrospective study was performed on all patients who underwent flap coverage of an elbow defect at our hospital. The patients' data including age, sex, cause of injury, wound dimensions, timing of flap coverage, postoperative elbow motion, and complications were investigated.
  
  
  RESULTS
  Between 2001 and 2012, 16 patients were treated at our hospital. The mean age was 53.3 years. Three kinds of flaps were performed: 9 latissimus dorsi flaps, 4 lateral arm flaps, and 4 radial forearm flaps. The average defect size was 183.5 cm(2) (range, 28 to 670 cm(2)). Wound coverage was performed at mean duration of 45.9 days (range, 14 to 91 days). The mean postoperative active elbow flexion was 98° (range, 85° to 115°). Partial flap failure occurred in 1 latissimus dorsi flap. Minor complications included partial flap loss (11.8%), hematoma (23.5%), seroma (35.3%), and wound infection (5.9%).
  
  
  CONCLUSIONS
  Flap selection for elbow reconstruction is determined by the defect size and the extent of the adjacent tissue injury. Elbow reconstruction using an island flap is a single-staged, reliable, and relatively simple procedure that permits initiation of early rehabilitation, thereby improving a patient's functional outcome.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Gi Yeun
authors.initials: GY
authors.lastname: Hur
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Song
authors.forename: Jong Wook
authors.initials: JW
authors.lastname: Lee
authors.forename: Hoon Bum
authors.initials: HB
authors.lastname: Lee
authors.forename: Sung Won
authors.initials: SW
authors.lastname: Jung
authors.forename: Jang Hyu
authors.initials: JH
authors.lastname: Koh
authors.forename: Dong Kook
authors.initials: DK
authors.lastname: Seo
authors.forename: Jai Ku
authors.initials: JK
authors.lastname: Choi
authors.forename: Young Chul
authors.initials: YC
authors.lastname: Jang