Electric contact burn and gracillis muscle cover

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pre op wound

after deridement

gracillis muscle with pedicle


muscle being insetted

post op day 10 healthy muscle and graft taken up
42 year old iraqi male suffered electric contact burn ,which resulted in loss of skin ,tendons and exposed bone.. Wound was debrided and VAC was applied and culture was done . Antibiotics according to culture were given.

After 10 days of VAC therapy decision to operate was taken. Bone was nibbled and gracillis flap was taken to cover it. Flap artery was connected end to side to anterior tibial artery and vein was connected end to end to venae comitantes. Patient was anticoagulated for 5 days and flap monitoring was done. After six days of surgery patient was discharged and put on ecosprin for one month. Regular dressing were done and flap epithelized rapidly .

Microvascular surgery is difficult in high voltage electric burn injuries as in these case . Electric current travels through neurovascular bundles. Dead bone is a good source of  infection, Muscle flap is good for these infected wounds . Patient will require secondary tendon reconstruction later on .


Dr Adhishwer Sharma
MBBS,MS Gen Surgery PGIMER Chd
Mch Plastic Surgery
brachialplexus7@blogspot.com
brahmanandclinic,com
8860650846





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