Staged Reconstruction of Bilateral High-Voltage Hand Electrical Burns Using Groin and Local Flaps in a Patient with Renal Dysfunction
- Author:
Sung Won JUNG
1
;
Tae Wan KIM
Author Information
- Publication Type:CASE REPORT
- From:Journal of Korean Burn Society 2025;28(2):38-42
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:High-voltage electrical burn injuries, though relatively uncommon, often cause extensive deep-tissue destruction and severe functional impairment. Although standard reconstructive algorithms are well established, simultaneous bilateral hand involvement in a patient with systemic comorbidity poses a unique reconstructive challenge requiring individualized flap selection and staged planning.Case: A 56-year-old man sustained bilateral high-voltage arc burns (22,900 V) on the bilateral hands. The left hand was identified as the entry site and the right hand as the exit site. Because of poor graft take after split-thickness skin grafting (STSG) with an acellular dermal matrix (ADM) and recurrent tendon exposure, a tailored reconstructive strategy was implemented.Negative-pressure wound therapy (NPWT) was used to enhance granulation, followed by a pedicled groin flap for the dominant right hand and sequential local advancement flaps with continued NPWT for the left. Both flaps survived completely achieving stable coverage and restoration of near normal motion (range of motion: right 0~90°, left 0~95°) at 3 months.
Conclusion:This case highlights that even in the absence of microsurgical options, staged reconstruction combining NPWT, pedicled groin flap, and local flaps can achieve durable wound closure and functional recovery in medically compromised patients with bilateral hand electrical burns. The key clinical message is that flap selection should be individualized based on wound characteristics, systemic condition, and the balance between surgical risk and long-term function.
