Supercharging Extra-Large Anterolateral Thigh Flaps for Single-Stage Resurfacing of Massive Burn Defects Over Upper Extremity Elbow Joints.

The resurfacing of soft tissue over extensor side of elbow joint after a full thickness burn injury is challenging due to greater amount of soft tissue needed. Local or regional flaps in the upper limb are not readily available and the use of free flap is the consensus. We want to present the first report of an extra-large anterolateral thigh (ALT) flap for a 1-stage coverage of an extensive elbow defect. The versatility of the ALT flap in design offers the surgeon the added option of supercharging the flap for increased survival when using a large flap for extensive wound coverage in the elbow. A 36-year-old male was admitted due to full thickness contact thermal burn over extensor side of left elbow. After debridement, we applied a 1-stage reconstruction with an extra-large ALT flap for the wound coverage and a supercharging design was made for the better perfusion for the flap. The flap was well perfused and the patient was discharged under stable wound condition as well as a fair functional outcome. The ALT flap is ideal for resurfacing large defects over the elbow and its anatomy and multiple source perforators allow the use of supercharging to enhance flap survival in the upper limb.