Complex Intraoral Reconstruction Using a Single Free Anterolateral Thigh Flap and Supermicrosurgery After Corrosive Ingestion in a 14-Month-Old Child

Abstract

Oral chemical burn injuries induce more damage to the underlying tissues with extensive scarring. It is very well known that alkali causes severe liquefaction necrosis and injury to the deeper tissues. Pediatric facial burns must be managed thoroughly and always require complex reconstruction, which is a challenging process. So, any reconstructive surgeon must be aware of all the deformities that may have significant functional and aesthetic impact on the burn survivors especially children. Few medical studies addressed pediatric microsurgical reconstruction for oral burn injuries induced by chemical materials. Anterolateral thigh (ALT) free flap is a common flap with a multitude of indications. The purpose of this article is to present the youngest case in the medical literature of caustic intraoral scarring managed with a very thin free anterolateral thigh flap in a 14-month-old child who underwent reconstruction of his inner cheek, the angle of the mouth and tongue using supermicrosurgery techniques. Further development of the surgical techniques is required to establish early and safe intraoral pediatric microsurgery with a long-term follow-up.

Free flap transfer with supermicrosurgical technique for soft tissue reconstruction: A systematic review and meta‐analysis

“…From 2520 citations, 383 articles remained after the first screening process. Following the second screening process, 47 studies were included in the systematic review (Figure 1) (Visconti et al, 2020; Choi et al, 2014; Daǧdelen & Aksoy, 2020; El Fahar, 2018; He et al, 2016; Hong, 2009; Hong et al, 2013, 2014, 2021; Hong & Koshima, 2010; Hwang et al, 2013a, 2013b; Iida et al, 2014, 2015, 2016; Iida et al, 2019; Jeong et al, 2018; Jin et al, 2015; Kim et al, 2010, 2013; Kim, Hong, et al, 2015; Kim, Kim, et al, 2015; Koshima et al, 1998, 2000; Koshima, Nanba, et al, 2003; Koshima, Tsutsui, et al, 2003; Narushima et al, 2011, 2013; Scaglioni, Meroni, & Fritsche, 2021a, 2021b; Scaglioni, Rodi, et al, 2021; Seo et al, 2015, 2018; Song et al, 2017; Suh et al, 2016; Sumiya et al, 2021; Tashiro et al, 2014; Tashiro et al, 2016, 2017; Vijayan et al, 2017; Wang et al, 2019; Wei et al, 2020; Yamamoto et al, 2016; Yoon et al, 2014; Yoshimatsu et al, 2017, 2019). Agreement between reviewers was substantial during the screening process (Cohen's k: 0.74, 97.4%).…”