Background and Objective

High voltage burn patients usually produce important distal limb injuries. Among challenges o to be faced there are the important destruction of deep tissues, the progress or late identification of tissue injuries, the vascular lesions that difficult the reconstruction and infections.

Our aim is to expose the cases dealt with and the experience gained for the first 5 years of our Burn Unit in Universitary Hospital Rio Hortega in Valladolid, Spain.

Methods

We present a 6 patients series with 8 upper limb injuries because of high voltage burns who were treated in our Burn Unit. We detail the epidemiological and reconstructive technique data and the timing in each case. We also detail the physiological disturbances of these patients.

Results

Eight flaps to reconstruct the 6 upper limbs and 2 amputations in the middle of forearm were needed. We used 6 free flaps, 1 local flap and 1 distant flap. Cutaneous/fasciocutaneous flaps and muscular flaps were used 6 and 2 times respectively and 100% of the patients presented high levels of creatine phosphokinase (CPK) because of muscular damage, 2 of them needed renal replacement therapy.

Conclusions

In order to achieve limb reconstruction after high voltage injuries, plastic surgeons have to use all the techniques, from skin grafts to free flaps, going through skin substitutes. However amputations and neurological alterations are frequent in these patients.

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