FREE FLAP RECONSTRUCTION IN PEDIATRIC PATIENTS – A SEVEN YEARS SINGLE INSTITUTIONAL EXPERIENCE

Abstract

Background: Microvascular surgery in the Pediatric age group is challenging due to technical difficulties in dealing with comparatively smaller vessel size. However, with enhanced magnification and better training, expertise in this area is improving.

Methods: A retrospective record review of all Pediatric patients who underwent microvascular reconstruction for various indications was undertaken. This study was performed at a tertiary care referral centre over a seven-year period (August 2010 to July 2017). Children under the age of15 years were included. Demographic profile, indications, operative records and outcomes were retrieved and analysed. Our experience in such cases and outcomes are presented.

Results: Records of a total of 48patients were identified and included in this study. The mean age was 9.5 years. Defects were most commonly located over the head and neck (n=24), followed by lower extremity (n=19) and upper extremity(n=5). The free flap was chosen based on the need and availability of tissue on a case-per-case basis. Re-exploration was required in 5 cases and complications occurred in 7 cases. The overall success rate was91.67%.

Conclusion: Microvascular surgery in children is safe and reliable. Considerably improved outcomes have been recently reported. The indications, success and complication rates are almost identical to adults. Availability of experienced surgical team, which has been a major hurdle, is now increasing available. Knowledge of multiple reconstructive options and mastering them of them seems essential for consistent results.