title: Early Reconstruction of Distal Leg and Foot in Acute High-Voltage Electrical Burn: Does Location of Pedicle in the Zone of Injury Affect the Outcome of Distally Based Sural Flap?
abstract: BACKGROUND
  Distally based fasciocutaneous sural flap is popular in the reconstruction of distal leg and foot burns. However, utilization of this technique in high-voltage electrical injury has been challenging.
  
  
  OBJECTIVE
  The present study aimed to compare the outcome of early aggressive debridement and coverage of contact point of acute high-voltage electrical injury using distally based fasciocutaneous sural flap between high-risk and low-risk patients defined by the anatomic proximity of the flap pedicle to the zone of injury.
  
  
  METHODS
  A total of 51 patients with contact point of high-voltage electrical burn (HVEB) in distal leg and foot undergoing distally based fasciocutaneous sural flap were included in this prospective clinical study. In 28 patients, the flap pedicle was not involved in the contact point of high-voltage electrical injury (low risk/control group), whereas in 21 patients, it was located inside the zone of injury (high-risk/case group). Patients were followed up for a median of 21 months (range, 12-44 months).
  
  
  RESULTS
  Wound dimensions to be covered were relatively similar between the 2 groups. Complications of flap survival (primary outcome) and other minor early and late complications (secondary outcome) did not significantly differ between the 2 groups (P > 0.05).
  
  
  CONCLUSIONS
  Provided that early and completed debridements of contact points of HVEB were achieved, distally based sural flap is feasible and there is reliable coverage in HVEB even in patients with flap pedicle located in vicinity of the zone of injury.
authors.affiliation: From the *Department of Plastic and Reconstructive Surgery, St Fatima Hospital, †Burn Research Center, ‡Department of Surgery, Motahari Burn Hospital, Iran University of Medical Sciences; and §Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Kamran
authors.initials: K
authors.lastname: Asʼadi
authors.forename: Seyed Hamid
authors.initials: SH
authors.lastname: Salehi
authors.forename: Saeed
authors.initials: S
authors.lastname: Shoar
mesh_terms: D000328:Adult; D002058:Burns, Electric / Q000601:surgery*; D003646:Debridement / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D018409:Foot Injuries / Q000601:surgery*; D006801:Humans; D007869:Leg Injuries / Q000601:surgery*; D008297:Male; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply*; D016896:Treatment Outcome