Free flaps to replace extensive and deep limb defects in children

Abstract

BACKGROUND: Extensive and deep limb defects remain a difficult problem of reconstructive surgery in children. Free microsurgical flaps are used to resolve this problem. Free flaps can be complex in composition and include muscles and bone parts, which allow replacing large and multicomponent limb defects. The technique is used in patients with posttraumatic deformities, burns, acquired limb deformities, and congenital deformities of the extremities.

AIM: To retrospectively analyze free flaps in children for the replacement of limb defects.

MATERIALS AND METHODS: This single-center retrospective study analyzed 120 cases of microsurgical autotransplantation of free flaps to replace defects of the upper and lower extremities in children. The patients were children aged 1–17 years who had injuries and burns, acquired limb deformities, and congenital limb deformities.

RESULTS: The average age of the patients was 9.5 years, and 72% of the patients were boys. Moreover, 95% of the children had posttraumatic deformities, burns, and acquired pathologies. Free latissimus dorsi flaps were used in 70% of the patients. The recipient area was the upper limb in 53% of the cases. The survival rate of free flaps was 96%. The general surgical complications were inflammation, pneumothorax, deformities, and specific vascular thrombosis.

CONCLUSIONS: Replacement of extensive limb defects with free flaps remains a practical method in children.

Keywords

microsurgery / free flap / posttraumatic deformities / congenital malformation / children

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