Using bipedicle abdominal flap to save left forearm and arm following a high-voltage electrical burn

Background: electrical injury is daily compromise of our life, upper and lower extremities are common sites of injury. case presentation: a 23 years old man who had suffered high voltage electrical injury referred to our center. he had severe left upper extremity burn and suffered from head and thoracic injuries due to falling down from high altitude. treatment: fasciotomy of the left forearm was done. muscle damage and myoglobinuria were managed. early reconstruction was performed for prevention of tendons and nerve necrosis. because of circumferential burning of the left forearm, bipedicle abdominal flap at the skin of left lower thorax and the abdomen was done. skin necrosis of the flap at the lateral epicondyle area of the bipedicle abdominal flap occurred. latissimus dorsi muscle pedicle flap was used for coverage of the lateral epicondyle area. learned lessons: local flap necrosis is an important complication of the bi-pedicle abdominal flap.