Volar forearm defect following high-voltage electrical burn managed with biodegradable temporizing matrix and split-thickness skin grafting: a case report

Abstract

High-voltage electrical burns involving the volar forearm present formidable reconstructive challenges due to exposure of tendons and neurovascular structures. We report the case of a 52-year-old male electrician from a rural setting who sustained a high-voltage contact burn to the right volar forearm during occupational exposure. Following fasciotomy and serial debridements, the wound bed demonstrated extensive tendon exposure that precluded immediate grafting. A biodegradable temporizing matrix (BTM) was applied to promote neodermis formation. The matrix integrated fully within three weeks, after which split-thickness skin grafting was performed with 85% graft take. At 12 weeks, the patient achieved full wrist and finger motion with no contracture or hypertrophic scarring. The use of BTM allowed preservation of function, avoided the need for flap reconstruction, and achieved durable coverage with satisfactory cosmetic and functional results. This case highlights the efficacy of BTM in managing complex upper-limb electrical burns in resource-limited settings.