Preexpansion of free flap donor sites used in reconstruction after burn injury.

Burn wound management usually can be achieved successfully without reliance on any free tissue transfers. This is true partly because tissue expansion techniques for the creation of local flaps have become increasingly versatile and are a simpler alternative when vascularized tissues are required. However, in special circumstances both concepts can be combined to further enhance reconstruction after burn injury. In addition, pretransfer expansion of free flap donor sites has many advantages over posttransfer expansion because not only is immediate primary donor site closure possible, but fabrication of flaps with desired characteristics of size and thickness can be specifically manipulated simultaneously.