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

Abstract

The purpose of this report is to evaluate the outcome ofmicrosurgical reconstruction of traumatic lower extremitydefects in children and compare fasiocutenous flaps withmuscle and musculocutaneous flaps. At Al-Azhar UniversityHospitals (Al-Hussien and Sayed Galal Hospitals) in the lasttwo years. 50 free tissue transfers had been performed in 50children. Patients ranged in age from 3 to 16 years old, Thedefect location included the dorsum of foot in 24 cases, medialaspect of foot in 4 cases, lateral aspect of foot in one case,forefoot in 2 cases, heel in 5 cases, ankle in one case, upperthird of leg in 3 cases, middle third of leg in 6 cases, lowerthird of leg in 4 cases and the knee in 2 cases. Flaps used inthis study were myocutenous and muscle flaps (L.D and R.F)in 38 cases, fasciocutenous flaps (A.L.T) in 7 cases, andchiemeric flap (L.D+S.A) in 5 cases. Hospital stay was rangedfrom 5 days to 14 days with an average of 8.8 days. Therecipient'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 onecase. The postoperative complications were seen in 13 patientsin the form of venous congestion in three cases, superficialinfection in five patients, delayed wound healing in threepatients, partial necrosis in one case, graft loss in one case,with total flap loss in three cases. One could conclude fromour report that a free fasciocutaneous flap is an excellentoption for lower extremity reconstruction. Our data indicatethat it can be successfully used in all clinical settings, withoutoutcomes equivalent to the more traditional muscle flap.