A Practical Flap Solution for Electric Burn Wounds of the Upper Limb

Authors

  • Mohammad Morshed Kamal Assistant Professor (Plastic Surgery), National Institute of Burn and Plastic Surgery, Dhaka, Bangladesh.
  • Md Shahin Assistant Professor (Plastic Surgery), National Institute of Burn and Plastic Surgery, Dhaka, Bangladesh.
  • Tanveer Ahmed Associate Professor (Plastic Surgery), National Institute of Burn and Plastic Surgery, Dhaka, Bangladesh
  • Mridul Kanti Sarker Assistant Registrar (Plastic Surgery), National Institute of Burn and Plastic Surgery, Dhaka, Bangladesh.
  • Rayhana Awwal Director and Professor, National Institute of Burn & Plastic Surgery, Dhaka, Bangladesh.
  • Md Sazzad Khondoker Retired, Professor and Head, Department of Plastic Surgery & Burn Unit, Dhaka Medical College Hospital, Dhaka, Bangladesh.

DOI:

https://doi.org/10.3329/jss.v27i2.86389

Keywords:

Paraumbilical perforator flap, electrical burn, upper limb reconstruction, hand and forearm reconstruction, soft tissue coverage

Abstract

 Background: High-voltage electrical burns often result in extensive soft tissue damage to the upper limb, particularly the hand and forearm. These injuries demand prompt and reliable reconstruction to restore function and minimise complications. In many centres, advanced microsurgical facilities are not readily available, making paraumbilical perforator-based flaps a practical and accessible solution for hand and forearm coverage. This study aims to assess the effectiveness of paraumbilical perforator flaps for reconstructing hand and forearm defects after electrical burns.

Methods: This prospective observational study included 48 patients with post-electric burn injuries to the hand and forearm. The study was conducted at the Sheikh Hasina National Institute of Burn and Plastic Surgery, Dhaka, and the Department of Plastic Surgery and Burn Unit, Dhaka Medical College Hospital, Dhaka, Bangladesh, between August 2017 and June 2019. All patients underwent reconstruction using paraumbilical perforator-based flaps. Data on flap design, operative technique, complications, flap survival, and clinical outcomes were collected and analyzed.

Results: The age ranged from 1-50 years. Total number of male patients was male 39 and female 9. Right hand involved in 31 cases, left hand involved in 16 cases and both hand in 1case. After excision, the wound length was ranged from 5cm to 20cm and wound width was ranged from 3cm to 8cm. The flap length was ranged from 10cm to 21cm and flap width was ranged from 4cm to 8cm. Primary closure of donor site done in all cases. All flaps survived, marginal necrosis was found in 3(6.25%) cases, all managed conservatively. Time of flap division was between 18-21days in 37(77.08%) cases and between 22-28days in 11(22.91%) cases. On assessment of the flap 45(93.75%) cases had good outcome and 3(6.25%) satisfactory.

Conclusion: The paraumbilical perforator flap is a reliable, practical option for upper limb reconstruction after electrical burns, especially in resource-limited settings.

Journal of Surgical Sciences 2023;27(2): 30-36

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Published

2026-04-21

How to Cite

Kamal, M. M., Shahin, M., Ahmed, T., Sarker, M. K., Awwal, R., & Khondoker, M. S. (2026). A Practical Flap Solution for Electric Burn Wounds of the Upper Limb. Journal of Surgical Sciences, 27(2), 30–36. https://doi.org/10.3329/jss.v27i2.86389

Issue

Vol. 27 No. 2 (2023)

Section

Original Articles

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