Retrospective Evaluation of Free Flap Usage in Burn-Related Defects: a Single-Center Experience
4th International Microsurgery Meeting Izmir, İzmir, Turkey, 26 - 28 September 2025, pp.2-7, (Full Text)
- Publication Type: Conference Paper / Full Text
- City: İzmir
- Country: Turkey
- Page Numbers: pp.2-7
- Bursa Uludag University Affiliated: Yes
Abstract
Free tissue transfer is an important reconstructive method in burn surgery, particularly for the closure of large and complex soft tissue defects. Although the treatment of soft tissue losses in burn patients can often be achieved with skin grafts, free tissue transfer may be required in cases where bone, tendon, or vascular structures are exposed. In this study, eight patients who underwent free tissue transfer between 2014 and 2017 in the Burn Unit of Bursa Uludağ University Faculty of Medicine were retrospectively evaluated, and a total of 11 free tissue transfers were performed. The most frequently used flap was the anterolateral thigh (ALT) flap, followed by lateral arm and latissimus dorsi flaps. The mean age of the patients included in the study was 51.4 years; seven were male and one was female. Total flap loss was observed in two patients (18.2%), and reconstruction was achieved with a split-thickness skin graft. This study aimed to retrospectively analyze burn patients who underwent free tissue transfer at a single center by collecting data on complications, existing comorbidities, and demographic characteristics. The complications observed included hematoma, partial necrosis, and detachment, while most flaps maintained their viability through surgical or medical interventions. The complication rate per flap was 68.2%, and the total flap loss rate was 18.2%. These findings are consistent with the literature, which indicates that free tissue transfer is a reliable option for acute burn reconstruction when appropriately indicated. While the success rate of free tissue transfer in the acute phase has been reported to exceed 90% in the literature, the higher flap loss rate (18.2%) and complication frequency in this series are thought to be related to the limited number of cases, as well as the size and heterogeneity of the defects. The findings support that free tissue transfer is a reliable reconstructive option in the acute phase after burns. In particular, the free ALT flap stands out due to its large skin island, long pedicle, and low donor site morbidity. Conclusion, free tissue transfer provides significant advantages in terms of functional recovery and limb salvage in burn patients. Timing, patient selection, perioperative attention, and an experienced surgical team are key factors for success. Our findings support the reliability of free tissue transfer in burn reconstruction and highlight the need for future multicenter studies with larger samples.