Clinical applications of free flap transfer in the burn patient.

Free microvascular flap transfer is indicated in situations in which flap coverage is required and no local flap is available. The technique of transfer of a groin flap based on the superficial circumflex iliac vessels was described. The procedure has been applied to two patients with acute electrical burns with extensive soft-tissue loss, three patients with scar contractures, and one with osteoradionecrosis. Satisfactory results were achieved in all patients. The procedure is contraindicated if recipient or donor vessels are abnormal or inadequate, and in the face of fulminating infection, general debility, and obesity. With scrupulous attention to indications and contraindications, the procedure is safe, reliable, and a valuable addition to the surgeon's armamentarium.