Toe Tissue Transfer for Reconstruction of Damaged Digits due to Electrical Burns

Background Electrical burns are one of the most devastating types of injuries, and can becharacterized by the conduction of electric current through the deeper soft tissue such asvessels, nerves, muscles, and bones. For that reason, the extent of an electric burn is veryfrequently underestimated on initial impression.Methods From July 1999 to June 2006, we performed 15 cases of toe tissue transfer for thereconstruction of finger defects caused by electrical burns. We performed preoperative rangeof motion exercise, early excision, and coverage of the digital defect with toe tissue transfer.Results We obtained satisfactory results in both functional and aesthetic aspects in all 15cases without specific complications. Static two-point discrimination results in the transferredtoe cases ranged from 8 to 11 mm, with an average of 9.5 mm. The mean range of motionof the transferred toe was 20° to 36° in the distal interphalangeal joint, 16° to 45° in theproximal interphalangeal joint, and 15° to 35° in the metacarpophalangeal joint. All of thepatients were relatively satisfied with the function and appearance of their new digits.Conclusions The strategic management of electrical injury to the hands can be both challengingand complex. Because the optimal surgical method is free tissue transfer, maintenance ofvascular integrity among various physiological changes works as a determining factor for thepostoperative outcome following the reconstruction.