Abstract

VILLAVERDE-DOMENECH, M.E. et al. The challenge of free flap transfers in burn patients: what is the best timing of surgery?. Cir. plást. iberolatinoam. [online]. 2015, vol.41, n.2, pp.117-126. ISSN 1989-2055.  https://dx.doi.org/10.4321/S0376-78922015000200001.

Free flap transfer is an essential tool within the reconstructive repertoire for the surgical treatment of major burn patients. For a long time there has been controversy about the influence of the timing over the complication rate, as well as the increased complication risk when we perform reconstruction by means of free flaps in burn patients. We designed a retrospective study about free flap reconstructions performed in our Burns Unit at the Hospital Universitari y Politecnic La Fe, Valencia ( Spain), in the period from 2001 to 2013, collecting data related to the patient, the lesion, the reconstructive procedure, the results, and all this data related to timing. For the data analysis and associations between the different variables we used contingency tables and applied the Chi-square independence test. In addition we present 2 representative clinical reports about burn reconstructive surgery. Data from 21 reconstructive procedures with free flaps in burn patients were collected. Immediate primary reconstruction (in the first 5 days) is not performed in any patient, while early primary reconstruction (from day 5 to 21) was performed in 28,57 % of cases; the intermediate primary reconstruction (from day 21 to 6th week) was performed in 28,57 %, the secondary reconstruction (more than 6 weeks) in 9,5 % and sequelae surgery in 33,33 % of the cases. Major and minor complication rate were 19,05 % and 9,5 % respectively; 50 % of major complications happened in early primary reconstruction period, whereas no complication is registered in intermediate primary period, the rest of complications are equally divided between secondary reconstruction period and sequelae surgery (both of them 25 %). No statistically significant association between the variables is found in any of the comparisons performed. In conclusion, we think that reconstruction with free flaps applied to burn patients presents a higher major complication rate when performed in the early primary period (from day 5 to day 21 after the burn).

Keywords : Free tissue flap; Vascularised flap transfer; Burn surgery; Complications in burned patients.

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