Arch Hand Microsurg 2019; 24(4): 381-387  
Salvage Procedure of a Lower Leg in a Contact Burn: Latissimus Dorsi Muscle Free Flap and Scalp Skin Graft
Suk Joon Oh1, Dukju Moon2
Departments of 1Burn Reconstructive Surgery and 2Burn Surgery, Bestian Seoul Hospital, Seoul, Korea
Correspondence to: Suk Joon Oh
Department of Burn Reconstructive Surgery, Bestian Seoul Hospital, 429 Dogok-ro, Gangnam-gu, Seoul 06208, Korea
TEL: +82-70-7609-9321, FAX: +82-70-7005-4233, E-mail: sjoh46@nate.com, ORCID: https://orcid.org/0000-0001-7793-6198
Received: July 1, 2019; Revised: August 19, 2019; Accepted: August 21, 2019; Published online: December 1, 2019.
© Korean Society for Surgery of the Hand, Korean Society for Microsurgery, and Korean Society for Surgery of the Peripheral Nerve. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Intentional carbon monoxide (CO) poisoning has become rapidly increased occurrence, also if the surviving patient is burnt and unconscious, the patient's burn wound is likely to be severely deep and to need flap surgery. A 44-year-old female patient suffered from a deep contact burn to the left posterior lower leg during intentional CO poisoning. The patient underwent escharotomy and treatment with a latissimus dorsi muscle neuro-vascularized free flap and scalp skin grafts. While harvesting 0.008 inches (300 cm2) of the scalp skin, some 25 cm2 of the skin was accidentally harvested as a thick split-thickness skin graft (SSG) from the right occipital scalp. Interfollicular epidermal and dermal regeneration was achieved at eleven days postoperatively at the thick SSG donor site. The patient's deep burn wound was reconstructed by two staged surgeries. The patient was able to walk with the help of a supportive shoe one year postoperatively.
Keywords: Poisoning, Burn, Free tissue flap, Scalp, Transplant


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