Thermal Burn in Patients with Replanted Fingers or Reconstructed Ones with Free Flap

Shim, Jin Hee; Ki, Sae Hwi; Kim, Jin Soo; Lee, Dong Chul; Roh, Si Young; Yang, Jae Won; Jeon, Man Kyung

Abstract

PURPOSE
In order to rehabilitate patients with replanted fingers or reconstructed ones with free flap, the warm therapy is cost-effective, clean, and easy to use. However, the risk of thermal burn in patients with replanted fingers or reconstructed ones with free flap is not clearly identified yet and only few clinical prognosis exist. For that reason, this study was designed to evaluate the incidence, characteristics and risk factors of thermal burn in patients with replanted fingers or reconstructed ones with free flap.
METHODS
We reviewed all the medical records of patients retrospectively, especially who showed clinically important thermal burn of replanted fingers or reconstructed ones with free flap from February 2010 to March 2011.
RESULTS
10 patients out of 370 with successfully replanted fingers or reconstructed ones with free flap presented clinically important thermal burn. (2.70% incidence). The causes of thermal burn were warm therapy (4 cases) and touching hot bowls such as a coffee cup, hot pot or hot grill (6 cases). Among them, 7 patients suffered superficial 2nd degree burn with bullae, 1 patient deep 2nd degree burn, 1 patient 4th degree burn and another 1, 1st degree burn with mild erythema. All of them except two cases were treated with conventional dressing with antibiotic ointment, while one was treated by skin graft and another one by 2nd toe pulp free flap. On the other hand, there were only 3 thermal burn cases among 7,010 patients who had undergone the hand surgeries other than replantation and free flap (0.04% incidence). And 2 were by warm therapy and 1 by hot pot. All of them were superficial 2nd degree burn with bullae and treated with conventional dressing with antibiotic ointment for about 1 week.
CONCLUSION
These results suggest that patients with replanted fingers or reconstructed ones with free flap are more likely to have thermal burn than any other. Therefore we should be aware of the possibility of thermal burn for these patients, paying more attention to prevent it during the warm therapy and letting them always keep an appropriate distance from anything that can cause thermal burn.