Salvage Procedure of a Lower Leg in a Contact Burn: Latissimus Dorsi Muscle Free Flap and Scalp Skin Graft

Oh,  Suk Joon; Moon,  Dukju

doi:2019.24.4.381

Arch Hand Microsurg > Volume 24(4); 2019 > Article

Case Report

Archives of Hand and Microsurgery 2019;24(4):381-387.
Published online December 1, 2019.
DOI: https://doi.org/10.12790/ahm.2019.24.4.381

Salvage Procedure of a Lower Leg in a Contact Burn: Latissimus Dorsi Muscle Free Flap and Scalp Skin Graft

Suk Joon Oh¹, Dukju Moon²

¹Department of Burn Reconstructive Surgery, Bestian Seoul Hospital, Seoul, Korea. sjoh46@nate.com
²Department of Burn Surgery, Bestian Seoul Hospital, Seoul, Korea.

Received: 1 July 2019 • Revised: 19 August 2019 • Accepted: 21 August 2019

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.

Key Words: Poisoning, Burn, Free tissue flap, Scalp, Transplant