The use of superficial and deep partial-thickness burned tissue for flap fabrication

Abstract. When flaps are indicated for early wound closure in extensive burns, and there is limited unburned local tissue to design these, one option may be to use a partial-thickness burned area as a flap for construction in the acute phase. This study examined the proportions of superficial and deep partial-thickness burned skin that can safely be included in an island flap. Eighty male Wistar rats were divided into four groups, with varying extent of burning of the right epigastric flap site: group 1, 50% superficially burned; group 2, 100% superficially burned; group 3, 50% deeply burned; and group 4, 100% deeply burned. In each group the left epigastric flaps served as controls. The superficially burned flaps in groups 1 and 2 healed at 2-4 weeks, and the deeply burned flaps in groups 3 and 4 healed at 4-6 weeks postoperatively. In all cases hair grew on the burned flap sites, and the flaps healed in such a way that they were almost impossible to distinguish, even after the hair was shaved at week 8. It was observed that the superficially burned flaps healed perfectly without scarring, but small portions of the deeply burned flaps developed scars. In conclusion, superficially and deeply burned island flaps survived completely in this animal model, even when the entire flap surface was burned. In the future, under appropriate conditions the transfer of partial-thickness burned tissue as flaps may provide a good alternative for reconstruction of the acute burn wound.