Thermal Injury During the Microvascular Free Flap: A Case Report

Cho, Hee Eun; Roh, Si Gyun; Lee, Nae Ho; Yang, Kyung Moo

Abstract

Thermal injury to free flap site can be severe and distressing injuries both for the patients and the surgeon. Thermal injuries to insensate free flaps are known complications often reported. But thermal injuries to free flaps are also occurred in the perioperative period. This study focused on the various factors associated with these injuries. We reported a 36-years old male patient with scalding burn in using warmed saline irrigation who underwent anterolateral thigh perforator free flap due to diabetic foot ulcer on dorsum of left foot. The clinical characteristics of thermal injuries during the free tissue transters are 1) Warmed saline irrigation is often too hot and a temperature excess 48degrees C should be considered very hot saline during the operation. 2) The direct exposure of the microscope light often causes iatrogenic burn, so copiously irrigating the surgical field and readjusting the light source's position or its output intensity are important. Surgeon must be aware that warmed saline irrigation & surgical microscope can cause thermal injury to free flap during the free tissue transfer.