Free perforator flap to repair traumatic skin and soft-tissue defects of limbs in children

Objective To investigate the feasibility and report the preliminary curative effects of perforator flaps for traumatic skin and soft-tissue reconstruction of limbs in children.Methods From August 2008 to January 2012,free perforator flaps were performed on 30 children,aged 2 to 10 years at the time of operation.Three children presented with upper limb defects; the remainin 27 children sustained major soft-tissue defects of the lower limb.All of them had significant exposure of the tendons and skeleton and the lesions necessitated extensive coverage with a free flap.Flaps used in this series included eighteen deep inferior epigastric artery perforator flaps(including one deep inferior epigagtric chimerical perforator flap),three thoracodorsal artery perforator flaps,five circumflex scapular artery perforator flaps,one anterolateral thigh perforator flap and three bilobed subscapular artery perforator flaps (compound thoracodorsal artery perforator flap with circumflex scapular artery perforator flap).The maximum flap was 16 cm× 6 cm + 11 cm× 6 cm in size and the minimum flap was 7 cm × 4 cm.The donor site of the flaps was closed directly.Results All flaps but two were alive with excellent color and quality and without extremely fat contour.The mean follow-up was 8 months (3 to 30 months).Donor-site and receptor-site were of primary healing in all patients but one.The patient obtained good function of limbs.The function of donor-sites was satisfactory.Conclusions In children,perforator flaps are valuable alternative to the traditional muscle or myocutaneous free flap. Key words: Surgical flap;  Microsurgery;  Transplantation