Introduction
Free microvascular tissue transfer can provide excessive tissue in one stage in extensive defects where loco regional flaps options cannot be performed. Thus, free flaps have been an important reconstructive option in burn reconstruction whenever neurovascular and skeletal structures exposed. This sophisticated technique needs surgical expertise and understatement of burn physiology rather than non-burn trauma cases. In this study, we are going to share our experience in burn reconstruction with free flaps.
Material-Methods
Between 2017 and 2021 we have performed 26 free flaps in 20 burn patients. 15 flaps in 12patients were performed in early phase (first 21 days of the injury). 60% of the flaps were skin flaps (anterior lateral thigh, radial forearm, scip, parascapular), 20% musculucutanoeus( latissimus dorsi, vastus lateralis), 10% fascia flaps ( temporal fascia, serratus anterior), 10% pure muscle flaps (gracilis, latissimus dorsi)
Results
2 free flaps in the early phase reconstruction and 1 free flap in the late phase were lost. The etiology of the flap loss was venous congestion in 3 cases and arterial occlusion due hematoma formation 1 case. Debridement of the necrotic flaps were delayed until demarcation formation settled and sub flap granulation formation provocation. Skin grafts were performed after debridement of these flaps. Other flaps were totally survived and no recurrence in contractures or defects were encountered.
Conclusion
Although free flaps have changed the reconstructive ladder to reconstructive elevator, performing these flaps have unique challenges in burn reconstruction such as prone to thrombosis in electric burns, hemodynamic instabilities, difficulties patient positioning due to sedation. Meticulous care should be taken and patients’ general condition should be well evaluated prior to free flap surgery.

**Introduction**
Free microvascular tissue transfer can provide excessive tissue in one stage in extensive defects where loco regional flaps options cannot be performed. Thus, free flaps have been an important reconstructive option in burn reconstruction whenever neurovascular and skeletal structures exposed. This sophisticated technique needs surgical expertise and understatement of burn physiology rather than non-burn trauma cases. In this study, we are going to share our experience in burn reconstruction with free flaps.
**Material-Methods**
Between 2017 and 2021 we have performed 26 free flaps in 20 burn patients. 15 flaps in 12patients were performed in early phase (first 21 days of the injury). 60% of the flaps were skin flaps (anterior lateral thigh, radial forearm, scip, parascapular), 20% musculucutanoeus( latissimus dorsi, vastus lateralis), 10% fascia flaps ( temporal fascia, serratus anterior), 10% pure muscle flaps (gracilis, latissimus dorsi)
**Results**
2 free flaps in the early phase reconstruction and 1 free flap in the late phase were lost. The etiology of the flap loss was venous congestion in 3 cases and arterial occlusion due hematoma formation 1 case. Debridement of the necrotic flaps were delayed until demarcation formation settled and sub flap granulation formation provocation. Skin grafts were performed after debridement of these flaps. Other flaps were totally survived and no recurrence in contractures or defects were encountered.
**Conclusion**
Although free flaps have changed the reconstructive ladder to reconstructive elevator, performing these flaps have unique challenges in burn reconstruction such as prone to thrombosis in electric burns, hemodynamic instabilities, difficulties patient positioning due to sedation. Meticulous care should be taken and patients’ general condition should be well evaluated prior to free flap surgery.

P.106 Free microvascular tissue transfers in high voltage electric burns: A single institute experience

Dear friends and colleagues,

We will be pleased to welcome you in Turin (Italy) for the 19th European Burns Association´s Congress in 2022. Italy is honored to hold the meeting of the European Burns Association for the second time, after Verona in 1995. Turin is easily reachable from everywhere in Europe, either travelling by car, train or choosing flight connections. During the meeting, held in the renewed industrial center of the main Italian historical automotive factory (i.e. Lingotto-FIAT), we will meet international burn specialists, focusing on standards of care, progresses in burn treatment, strategies to face disaster situations, with a special attention to education of younger colleagues. However, in your spare time, you might enjoy the sweet days of Italian late summer, simply wandering in the green parks and gardens along the two rivers which cross the city, or you might decide to discover the numerous art galleries, churches, palaces, libraries, walking across elegant squares and large boulevards, passing through centuries of art and history; finally, you may choose to immerse yourself in some of the most exciting museum experiences, such as the Cinema Museum and the Turin’s Egyptian museum.

Looking forward to seeing you all in Turin for the 19th European Association´s Congress in 2022!
Maurizio Stella, Congress President, Turin Burn Centre