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Large-Scale Skin Resurfacing of the Upper Extremity in Pediatric Patients Using a Pre-Expanded Intercostal Artery

Jiao Wei1, Tanja Herrler2, Bin Gu1

  • 1Department of Plastic and Reconstructive Surgery, Shanghai Jiaotong University School of Medical, Ninth People's Hospital, Shanghai, People's Republic of China.

The Journal of Craniofacial Surgery
|February 28, 2018
PubMed

Insights

This study introduces an oversized preexpanded flap using intercostal artery perforators for repairing large pediatric upper limb skin defects, offering a viable reconstructive solution with minimal donor site issues.

Area of Science:

  • Plastic Surgery
  • Pediatric Reconstructive Surgery
  • Tissue Expansion Techniques

Background:

  • Pediatric upper limb skin lesion repair presents challenges due to flap size limitations and donor site morbidity.
  • This study aimed to develop an oversize preexpanded flap utilizing intercostal artery perforators for extensive pediatric upper extremity resurfacing.

Observation:

  • Eleven pediatric patients with extensive upper limb skin lesions were treated using preexpanded intercostal artery perforator flaps.
  • Tissue expansion averaged 133 days, achieving a mean final volume of 1713 mL.
  • Flaps were based on 2-6 pedicles, resurfacing a mean defect area of 238 cm².

Findings:

  • The preexpanded intercostal artery perforator flap facilitated single-stage repair of large skin defects on the upper limb.
  • Primary donor-site closure was successful in all cases.
  • Marginal necrosis occurred in 5 cases, with satisfactory aesthetic and functional outcomes reported for reconstructed limbs.

Implications:

  • This pedicled flap technique offers a valuable method for extensive upper limb skin lesion repair in children.
  • The approach minimizes donor-site morbidity, making it particularly suitable for pediatric reconstructive surgery.
  • Oversize preexpanded flaps provide a promising solution for complex pediatric limb reconstruction.
Abstract

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