Free anterolateral thigh flap for coverage of scalp large defects in pediatric burn population

Free anterolateral thigh flap is considered by most surgeons to be the proper choice for restoring scalp defect in the adult population. However, in the pediatric burn population with scalp large defects, the use of this flap has not been well described. From December 2005 to June 2009, 11 free anterolateral thigh flaps were performed to cover scalp defects in eight male children and three female children aged between 3.1 and 5.9 years (mean age: 5.0 years). Causes for the lesions include boiling liquid (5 cases), frictional heat (4 cases), and electricity (2 cases). Defect sites include parietal region (6 cases), occipital region (3 cases), temporal region (1 cases), and forehead (1 case). The size of the flaps ranged from 10 to 25 cm in length and from 8 to 18 cm in width. All the patients were followed up from 5.0 months to 2.1 years after the operation. Satisfactory contour results were shown. The overall flap success rate was 100%. There were no complications such as infections or hematomas after surgery. All the donor sites were covered with no morbidity observed. The free anterolateral thigh flap provides immediate vascularized coverage in scalp large defect that were unable to be treated by other methods, such as local flap or tissue expansion. Despite the smaller diameter of the vessels in pediatric population than that in adults, it is conceivable that this flap should be the reasonable and reliable method of large scalp defect coverage in pediatric population.