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
