The article analyses the results of free transplantation of skin grafts with axial blood supply in 45 patients with IV degree burns and their sequelae. Bearing in mind the peculiarities of damage to the tissues and vessels in a thermal trauma, it is advisable to anastomose the vein grafts with the large subcutaneous veins. Skin grafts with a long vascular pedicle are preferable. The difficulties which are encountered in the choice of the surgical tactics and in planning the operative intervention in patients with multiple areas with IV degree damage or their combination with extensive III degree burns insistently dictate the need for stricter indications for microsurgical transplantations, and rational and substantiated combination of plasty by free grafts and skin flaps with an axial blood supply type.
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