Clinical Efficacy of Double Skin Paddle Anterolateral Thigh Flap in High-Voltage Electrical Burns of the Wrist and Hand.

Objective: The aim of this study was to investigate the clinical efficacy of a free double skin paddle anterolateral thigh (ALT) flap in treating 2 separate high-voltage electrical burn wounds affecting the wrist and hand.

Methods: A retrospective observational study was conducted, involving 25 patients who met the inclusion criteria between January 2019 and December 2023. The initial treatment protocol included an early emergency fasciotomy and vascular reconstruction. This was subsequently followed by wound repair employing a double skin ALT flap in the next stage of treatment.

Results: Twenty-five double skin paddle ALT flaps were utilized for treating wrist and hand burn wounds in 25 male patients, aged 15-61 years. They comprised 21 cases of classic double skin paddle ALT flaps, 3 cases of artificial double skin paddle ALT flaps, and 1 case of a flow-through double skin paddle ALT flap. The dimensions of skin flaps ranged from 8 cm × 6 cm to 22 cm × 13 cm. Twenty-five ALT flaps were utilized, with 22 surviving completely. Complications included venous congestion (1 case), arterial thrombosis (1 case), and abscess (1 case), all managed surgically. The donor site was directly sutured and healed primarily in 19 cases, while a partial-thickness skin graft was used for closure in the remaining 6 cases. During a follow-up period ranging from 3 to 22 months, both the recipient and donor sites exhibited satisfactory healing, with no reported episodes of infection or abnormal discharge.

Conclusions: The utilization of a free double skin paddle ALT flap has led to satisfactory outcomes in treating 2 separate complex high-voltage electrical burn injuries to the wrist and hand. This technique achieves favorable reconstructive results, marked by minimal donor site morbidity, and it provides valuable insights into the management of similar cases.