Microsurgical flaps for limb salvage in children

We evaluated the results of microsurgical flaps for wound coverage in limb salvage cases at Arkansas Children's Hospital. Ages ranged from one to 18 years with a mean of 7.7 years. Sixteen children with soft tissue defect in 18 limbs were reconstructed with 19 free tissue transfer. Only one out of 19 free flaps failed, which necessitated a second free flap, giving an overall initial flap success rate of 95%. One flap developed superficial muscle necrosis, requiring debridement followed staged skin graft. All limbs were successfully salvaged. Our series confirms that microsurgical flap surgery is safe and effective in children, with limb salvage approaching 100 percent.