ABSTRACT
Twenty-two elective free-tissue transfers for reconstruction of various defects were
performed in 20 pediatric patients over a 7-year period. Patient ages ranged from
5 to 17 years (mean: 12.5 years). There were six open wounds, six unstable scars,
five tumor resection defects, three facial gunshot wounds, one facial paralysis, and
one penis agenesis. Ten free flaps were transferred to the head and neck region, seven
to the lower extremity, four to the upper extremity, and one to the genital area.
Ten fasciocutaneous flaps, seven muscle or myocutaneous flaps, and five vascularized
bone grafts were transferred. All flaps survived, except for one in an electrical
burn patient. The success rate was 95 percent. No vessel spasm was observed. Children
tolerated long operation periods better than adults. The recovery time after surgery
was considerably shorter than in adults. The mean operative time was 6 hr, and the
average hospital stay was 12 days. The mean follow-up period was 27 months. Results
of this study indicate that microvascular free-tissue transfer is a safe and reliable
method for the reconstruction of various defects in children.
