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Pediatric free tissue transfer: an evaluation of 99 cases
H M Clarke1, J Upton, R M Zuker
1Division of Plastic Surgery, Hospital for Sick Children, Toronto, Ont.
Objective:
To evaluate the results of free tissue transfers in children who undergo reconstructive surgery.
Design:
Case series chart review. Mean follow-up longer than 2 years.
Setting:
Two tertiary care pediatric hospitals.
Patients:
Consecutive sample of 99 children.
Interventions:
Free tissue transfers for reconstruction of a variety of defects.
Main Outcome Measures:
Indications, operations, complications, survival.
Results:
The most common indications were for restoration of muscle function and for difficulties with soft-tissue coverage. Multiple donor sites were used, with the gracilis muscle, fibula, latissimus dorsi and groin flaps predominating. The overall survival rate was 99.0%. Complications were common, with an overall rate of 59.6%; most were graded as minor or moderate.
Conclusions:
Meticulous planning is paramount in achieving a successful outcome. Complications are common but do not include vascular spasm. Free tissue transfers can be successfully completed in small children despite the dimensions of the tissues.