Immediate fascial flap reconstruction of joints and use of Biobrane in the burned limb

There is a small percentage of burned patients who would benefit from early excision of burns and coverage of exposed large joints to prevent septic arthritis and preserve movement. There are many reports in the literature on flap coverage of exposed joints or delayed primary excision of burns with subsequent flap coverage, but the immediate excision of burn to fascia with use of local vascularized fascial flaps to cover open knee and ankle joints has not apparently been described. This case report illustrates the basic plastic surgery techniques involved and the rationale behind such aggressive management. Biobrane is an extremely useful dressing for the coverage of such wounds in the interim period before autografting and provides ideal temporary coverage of vascularized fascial flaps and the excised burn bed.