Comparing the Versatility of Anterolateral Thigh (ALT) Free Flap and Superficial Circumflex Iliac Artery Perforator (SCIP) Free Flap for Hand Reconstruction Due to Electric Burn Injuries: Case-Based Literature Review

Electrical injuries, often caused by high-voltage currents from sources like arc flashes or ignited clothing, frequently result in extensive burns, particularly to the hands. The upper extremities, being common contact points for electrical injuries, are susceptible to severe tissue damage, including burns, nerve, muscle, and vascular damage. High-voltage electrical burns often require surgical intervention, with an emphasis on restoring both function and form. This study aims to compare the effectiveness of two free flap techniques—Anterolateral Thigh (ALT) and Superficial Circumflex Iliac Artery Perforator (SCIP)—in the reconstruction of hand burns resulting from electrical injuries. Authors conducted a literature review based on cases from the burn unit at Pertamina Central Hospital, Jakarta, focusing on two patients who underwent reconstruction using the ALT and SCIP free flaps. The ALT free flap, characterized by its versatile and reliable tissue coverage, was utilized in one case, while the SCIP free flap, known for its thin and pliable tissue, was employed in the other. The study reviews the anatomy, advantages, and limitations of each flap, considering factors such as functional outcomes, aesthetic results, donor site morbidity, and surgical complexity. Both techniques were shown to offer significant benefits in reconstructing complex burn injuries, with the ALT flap providing robust coverage and the SCIP flap offering superior contour and functional outcomes for smaller defects. The findings underscore the versatility of both flaps in electrical burn reconstruction, highlighting the importance of choosing the appropriate technique based on the size and location of the defect. This study contributes valuable insights into the selection of free flap techniques for reconstructing hand injuries caused by electrical burns, aiming to optimize patient outcomes in terms of both functionality and aesthetics.