Repairment of head soft-tissue defect after electrical injury with free ALTP flap

Objective: To investigate the feasibility and effectiveness of free ALTP flap in the repairment of the large head soft-tissue defect after electric shock injury. Methods: In this study, 25 patients underwent the reconstruction to repair the defect of the head by ALTP, including 18 males and 7 females (mean age:43 years; ranged 20 to 53 years). The etiologies of all patients were electric shock. The location of the defects involved 11 occipitalia,6 tempus,3 forehead and 5 crown, while the dimension of the defects ranged 7*5 to 21*10 cm 2 (mean 18.5*9.5 cm 2 ). Results: 25 patients were successfully treated by ALTP. Reconstructions were performed at the second stage in all cases, and all flaps survived completely. The donor sites were closed primarily in nearly all cases with an exception of 5 cases, which were covered with skin-grafting. The Pain Score was from 0 to 45 points with an average of 20 points. The score of Vancouver Scar Scale of donor sites was from 2 to 5 points with an average of 3.4 points. All flaps were followed-up for an average of 16 months (ranged from 6 to 24 months). No significant effect on quadriceps muscle strength and knee movement. Most cases showed satisfactory outcomes. Conclusion: The use of free ALTP for the repairment of large head defects after electroshock injury is worthy of clinical promotion and application because of its strong resistance to infection, high repair fit and rapid postoperative recovery.