Lower limb salvage in severely injured burned patients with bone or tendon exposure may be a reconstructive challenge. In this cases, local or regional flaps and other more
conservative therapies such as dermal substitutes and
negative-pressure wound therapy are usually not available or are not good enough to solve the problem. In such situations, microsurgical reconstruction with distant flaps seems to be the best option, even though the particularities of the severe
burn patient may decrease
free flaps' success rate. We report the case of a patient with severe electrical
injuries affecting 70% of the total body surface area who had full-thickness
burns to the lower extremity with wide bone exposure and extensively
drug-resistant
Pseudomonas aeruginosa infection. We achieved limb salvation using rectus femoris muscle
free flap plus lateral and medial gastrocnemius muscle flaps and soleus muscle flap, after two failed microsurgical coverture attempts and a long not useful periplus with
conservative therapies such us
negative-pressure wound therapy and dermal substitutes. After 3 years of follow-up, the patient can walk without aid, and he has recovered his social and employment situation prior to the accident.