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J Reconstr Microsurg 2012; 28(09): 589-594
DOI: 10.1055/s-0032-1315785
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Reconstruction of Lower Extremity with Perforator Free Flaps by Free Style Approach in Pediatric Patients

Jin Woo Song
1   Department of Plastic Surgery, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea
,
Muneera Ben-Nakhi
1   Department of Plastic Surgery, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea
,
Joon Pio Hong
1   Department of Plastic Surgery, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea
› Author Affiliations
Further Information

Publication History

23 January 2012

21 March 2012

Publication Date:
18 June 2012 (online)

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Abstract

Pediatric reconstruction using microsurgery is accepted normal practice, and the use of perforator flaps is slowly increasing. This study presents clinical work using various perforator free flaps by free style approach to reconstruct lower extremity soft tissue defects in pediatric patients and evaluates its efficacy. Between June 2002 and February 2011, 32 cases (mean age: 10.1 years) were reconstructed with free style perforator free flaps. Retrospective evaluations for flap survival, growth character, and other associated morbidities were performed. Flaps used in this series are anterolateral thigh (ALT) perforator, superficial circumflex iliac artery perforator (SCIP), upper medial thigh perforator, and posterior interosseous perforator free flaps. The free style approach for pedicle dissection was successful in all cases. Early postoperative complications were 15.6% from hematoma collection to partial loss of flap. Although there was no total loss in this series, one case needed additional flap coverage to cover the partial loss of the flap. The long-term follow-up showed contracture along the margin, with 16% needing a releasing procedure. Bone growth was not affected by flap contracture. The overall results show perforator flaps using the free style approach to be a reliable and feasible approach for lower extremity reconstruction in the pediatric population.

Keywords

pediatric reconstruction - free style reconstruction - perforator flaps
 

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