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A 16-year-old male presented with a high-voltage electrical burn affecting the scalp, resulting in a 25 cm x 10 cm lesion, and third-degree burns on the right fifth toe and the base of the left first metatarsal. Initial management included a medial plantar flap for the pelvic limb injury, but perfusion failure led to the use of a reverse posterior tibial flap for coverage, along with a split-thickness skin graft. For the scalp injury, a triple rotation flap technique achieved adequate coverage. Four-day postoperative follow-up showed successful perfusion of the reverse tibial flap without complications, highlighting the challenges and need for adaptive surgical strategies in managing high-voltage electrical burns.
Covarrubias et al. (Mon,) studied this question.