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A 12-Year Experience in Lower Extremity Acute Burns Reconstruction

Mario Alessandri-Bonetti, Tiffany Jeong, Guy M Stofman, Francesco M Egro.
University of Pittsburgh Medical Center

Presenter: Mario Alessandri-Bonetti

I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting.

Director Name: Vu Nguyen

Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction


A paucity of studies investigated the outcomes of flap reconstruction in lower extremity acute burn. The aim of this study is to report a single-center experience in lower extremity acute burns needing flap coverage.


We conducted a retrospective study to review patients with lower extremity acute burns needing either pedicled or free muscle flap coverage between August 2010 and December 2022.


Over a 12-year period, out of 901 burn patients requiring plastic surgery assistance for soft tissue reconstruction, 27 patients underwent 31 muscle flaps for lower extremity acute burns. In total, 81.5% were males and 18.5% females (mean age was 47+-12 years, mean BMI was 28.4+-7.2). Anatomical distribution of injured areas was lower leg (80.5%), knee (13%) and foot (6.5%). The most frequent indication for flap coverage was bone exposure (74%). Out of 31 flaps, 23 were pedicled muscle flaps (12 gastrocnemius flaps, 10 soleus flaps, 1 anterior tibial muscle flap) and 8 were free muscle flaps (6 rectus abdominis flaps, 1 vastus lateralis flap, 1 latissimus dorsi flap). Overall complications rate was 48.4% (n. 15). In the free flap group, at least one complication occurred in 62.5% (n. 5) of the cases, including 2 free flaps loss (25%). Complication rate in the pedicled flap group was 43.5% with no flap loss.


Flap coverage in lower extremity acute burns is rarely employed. However, it is important to be aware of the high risk of complications, especially for more complex reconstructions needing a free tissue transfer.

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