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Microsurgical reconstruction in pediatric patients: a series of 30 patients
Arzu Akçal1, Semra Karşıdağ, Deniz Özgür Sucu
1Deparment of Plastic and Reconstructive Surgery, Akdeniz University Faculty of Medicine, Antalya, Turkey. ozcanarzu79@yahoo.com.
Insights
Free flap surgery is a reliable reconstructive option for pediatric patients, offering excellent functional and aesthetic outcomes. This technique demonstrates adaptability and promotes better learning capacity in children, ensuring satisfactory results.
Area of Science:
- Pediatric reconstructive surgery
- Microsurgery
- Tissue transplantation
Background:
- Free flap surgery is increasingly accepted in pediatric cases due to its proven utility and reliability.
- Early concerns regarding the feasibility of free flaps in children have been largely resolved.
- This study evaluates the application and outcomes of free flap surgery in a pediatric cohort.
Observation:
- Thirty pediatric patients (15 boys, 15 girls) with a mean age of 10.8 years underwent free flap procedures.
- Defects were primarily located on the lower extremity (22 cases), followed by head and neck (5 cases) and upper extremity (3 cases).
- Etiologies included trauma (vehicle accidents, burns, crush injuries, gunshot wounds) and other conditions like epulis.
Findings:
- A variety of free flaps were utilized, including latissimus dorsi, serratus anterior, scapular, parascapular, fibular, anterolateral thigh, and others.
- The study details the diverse range of free flap techniques employed for complex pediatric reconstructions.
- Specific flap types were chosen based on defect location and etiology, demonstrating surgical versatility.
Implications:
- Free flaps in children offer advantages such as better flap growth adaptation and enhanced learning capacity.
- These benefits contribute to more satisfactory functional and aesthetic results for young patients.
- The findings support the continued use and refinement of free flap techniques in pediatric plastic and reconstructive surgery.
Background:
Free flap surgery in the pediatric population has gained widespread acceptance regarding its technical utility and reliability. Initial concerns as to the feasibility and reliability of the procedure in children were resolved over time.
Methods:
Thirty children (15 boys, 15 girls) were treated in Sisli Etfal Training and Research Hospital, Plastic and Reconstructive Surgery Clinic. Their mean age was 10.8 years. Defects were located on the lower extremity (n=22), head and neck (n=5) and upper extremity (n=3). The etiologies of the defects included vehicle accident, sequelae of burn, traumatic contractures, crush injury, epulis in the maxilla, and gunshot wound.
Results:
The free flaps performed in our series were latissimus dorsi muscle flap, combined latissimus dorsi and serratus muscle flaps, serratus anterior muscle flap, cross latissimus dorsi muscle flap, scapular osteomyocutaneous flap, parascapular fasciocutaneous flap, fibular osteocutaneous flap, anterolateral thigh flap, medial circumflex femoral artery perforator flap, and crista iliaca osteocutaneous flap.
Conclusion:
The advantages of free flaps in children, which include better adaptation of the flap growth and better learning capacity of the children, provide the surgeon with more satisfactory functional and aesthetic results.
