Pedicled Flaps for Coverage of Soft-tissue Defects in Children
Abstract
Introduction: The aim of this study is to evaluate the results achieved using pedicle flaps for coverage of soft-tissue defects in children.Material and Methods: Thirteen children who suffered trauma or burn of the extremities, with soft-tissue loss or severe retraction, requiring a pedicled flap for adequate coverage, treated between 2004 and 2013, were retrospectively evaluated. Patient’s age averaged 7.9 years .Time between initial trauma and flap coverage averaged 39 days. Coverage was achieved using a sural flap in four cases, a neurovascular island flap (Littler) in two cases, a radial forearm flap in two cases, a groin flap three cases, an abdominal flap in one case and a latissimus dorsi flap in one case. In all cases associated lesions were repaired or reconstructed at the same surgical procedure.Results: Follow-up averaged 19 months. Adequate coverage was achieved in all 13 cases. In 13 cases we obtained good coverage of the defect. Hospitalization time averaged 8.1 days. One patient developed infection, one flap had superficial necrosis and two patients developed hypertrophic scars. Two patients needed extensor tendon tenolisis and two needed z-plasties. All patients who had lower limb defects returned to sports with no limitations.Conclusion: Despite the growing number of free flaps being described, pedicled flaps allow adequate coverage in most soft-tissues defects in children; since they allow good coverage of bone, tendons and neurovascular structures; being possible to simultaneously reconstruct all associated injuries. The disadvantages of using these flaps in adults is immobilization of the affected limb, with potential stiffness and edema formation, but this was not evident in the children included in this series.Downloads
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