Parascapular free flap in electric burn coverage: case report

Abstract

Introduction. Upper limb reconstruction represents a challenge. Electrical burns produce devastating injuries in which free flaps are one of the best alternatives for early coverage with satisfactory results.

Clinical case. A 46-year-old man with high-voltage electrical burns involving 35% of the total body surface area; the burns, which were 2nd and 3rd degree, were located on the trunk and extremities. The patient, who was managed by the intensive care unit, plastic surgery, orthopedics and wound clinic, presented a residual coverage defect in the wrist, compromised median nerve and ulnar artery, exposed flexor and extensor tendons and radial artery without injuries. On hospital day 23, reconstruction of the median nerve was performed with a sural nerve graft, and coverage with a parascapular free flap. At four months postoperative he had a satisfactory evolution.

Conclusion. The subscapular system allows chimeric free flaps to be performed, useful for releasing contracted joints, reducing the risk of infection, protecting vital structures and reducing hospital stay, as well as helping to avoid amputation and allowing early rehabilitation.