Reconstruction of the soft-tissue defects of the limbs in children by free circumflex scapular artery perforator flap

Abstract

Objective To explore the feasibility of free circumflex scapular artery perforator flap for repairing the wounds of the limbs in children. Methods From April, 2010 to October, 2017. 39 cases of pediatric patients who suffered from skin and soft defects in the limbs with exposure of bone, joint or tendon were repaired by the circumflex scapular artery perforator flap.The flap size ranged from 6.0 cm×3.5 cm to 16 cm×14 cm. Doppler detection was used to determine the distribution of the descending, ascending and transverse branches of the circumflex scapular artery. The proper perforator flap type was selected according to the shape and the size of the wound. Results Thirty-seven flaps survived smoothly. Venous crisis occurred in one case and arterial crisis occurred in another case at the second postoperative day. Both flaps survived completely after exploration. All flaps were healed at the recipient sites. Delayed healing of the donor site wound occurred in two cases. All cases were followed up for 3 to 36 months (average 12 months), and the appearance and function of the recipient sites were satisfactory. Only linear scars remained in the donor sites. Conclusions The free circumflex scapular artery perforator flap is an ideal method to resurface the soft-tissue defects of extremities in children. Key words: Circumflex scapular artery; Perforator flap; Limbs; Tissue repair; Child