Microsurgical Reconstruction of Traumatic Lower Extremity Defects in Pediatric Patients: Is Fasciocutanous Flap A Versatile Tool to Replace Musculocutaneous Flap?

Ayad, Wael; ElGamal, Mohammad; Farahat, Ayman; El Batawy, Amr

doi:10.21608/ejprs.2019.65171

Microsurgical Reconstruction of Traumatic Lower Extremity Defects in Pediatric Patients: Is Fasciocutanous Flap A Versatile Tool to Replace Musculocutaneous Flap?

Document Type : Original Article

Authors

The Department of Plastic, Reconstructive and Burn Surgery, Faculty of Medicine, Al-Azhar University

10.21608/ejprs.2019.65171

Abstract

The purpose of this report is to evaluate the outcome of
microsurgical reconstruction of traumatic lower extremity
defects in children and compare fasiocutenous flaps with
muscle and musculocutaneous flaps. At Al-Azhar University
Hospitals (Al-Hussien and Sayed Galal Hospitals) in the last
two years. 50 free tissue transfers had been performed in 50
children. Patients ranged in age from 3 to 16 years old, The
defect location included the dorsum of foot in 24 cases, medial
aspect of foot in 4 cases, lateral aspect of foot in one case,
forefoot in 2 cases, heel in 5 cases, ankle in one case, upper
third of leg in 3 cases, middle third of leg in 6 cases, lower
third of leg in 4 cases and the knee in 2 cases. Flaps used in
this study were myocutenous and muscle flaps (L.D and R.F)
in 38 cases, fasciocutenous flaps (A.L.T) in 7 cases, and
chiemeric flap (L.D+S.A) in 5 cases. Hospital stay was ranged
from 5 days to 14 days with an average of 8.8 days. The
recipient's vessels were anterior tibial vessels in 38 cases,
posterior tibial vessels in 7 cases, femoral vessels in 2 cases,
dorsalis pedis vessels in 2 cases, and popliteal vessels in one
case. The postoperative complications were seen in 13 patients
in the form of venous congestion in three cases, superficial
infection in five patients, delayed wound healing in three
patients, partial necrosis in one case, graft loss in one case,
with total flap loss in three cases. One could conclude from
our report that a free fasciocutaneous flap is an excellent
option for lower extremity reconstruction. Our data indicate
that it can be successfully used in all clinical settings, without
outcomes equivalent to the more traditional muscle flap.

Keywords

Main Subjects

Reconstructions post

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