Free Flap Reconstruction of Foot and Ankle Defects in Pediatric Patients: Long-Term Outcome in 91 Cases

Abstract

Free tissue transfer in pediatric patients is a viable and reliable option. Skin/musculocutaneous flaps and skin-grafted muscle flaps both had equal survival rates; however, flaps with a skin component required fewer secondary procedures to correct deformities. Whenever a skin component was present, it provided useful tissue during the secondary procedure and minimized complications. For plantar foot reconstructions, skin-grafted muscle flaps demonstrated a higher incidence of trophic ulcers and a higher need for resurfacing procedures than flaps with a skin component. Reconstructions of tendons in the immediate setting led to fewer secondary operations than staged tendon reconstructions.

Simultaneous Extended ALT Flaps for Foot Salvage After Severe Frostbite

“…11,12 A thick skin graft was reported to be used for foot coverage and proved to regain some sensation. 13 Better plantar load distribution was reported when lipofilling was added to skin grafts. 14 Although several methods for large plantar defects reconstruction have been reported, 3,4,10 free flaps remain the method of choice.…”

Distally Based Saphenous Neurocutaneous Perforator Flap: A Versatile Donor Site for Reconstruction of Soft Tissue Defects of the Medial Malleolar Region

“…Free flaps can be procured from a variety of donor sites, and proper selection and harvest will limit donor site morbidity. Free flaps are, however, time-consuming and technically difficult to use and require the skills of experienced microsurgeons to be effective (10).…”

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

“…Today, high success rates and good results in pediatric free flap reconstruction have been reported. [5][6][7]12,[15][16][17][18] To achieve good results from pediatric microsurgery, Serkan et al recommended the use of microequipment under a high-magnification field of view, careful detachment of the vessels, use of local vasodilators such as lidocaine, control of postoperative pain, and prevention of vasospasticity with the use of splinting. 5 This approach was no different in reconstruction with the freestyle approach for perforator flaps.…”