gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Free flaps reconstruction in pediatric patients for limb defects

Meeting Abstract

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  • presenting/speaker Raquel Bernardelli Iamaguchi - University of Sao Paulo, Sao Paulo, Brazil
  • Gustavo Bersani Da Silva - University of Sao Paulo, Sao Paulo, Brazil
  • Alvaro Baik Cho - University of Sao Paulo, Sao Paulo, Brazil
  • Teng Hsiang Wei - University of Sao Paulo, Sao Paulo, Brazil
  • Marcelo Rosa De Rezende - University of Sao Paulo, Sao Paulo, Brazil
  • Rames Mattar Jr - University of Sao Paulo, Sao Paulo, Brazil

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1086

doi: 10.3205/19ifssh1235, urn:nbn:de:0183-19ifssh12356

Veröffentlicht: 6. Februar 2020

© 2020 Iamaguchi et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objectives/Interrogation: Free flaps in the pediatric population are less common and when indicated the expectations to avoid amputation is high. The objective of this study is to describe indications and results of free flaps for limb reconstruction in pediatric patients

Methods: From July 2014 to January 2018, patients undergoing microsurgical free flaps in an Orthopedic Hospital were consecutively included in this cross-sectional study. Data regarding personal medical history, intraoperative microsurgical procedure and laboratory tests were collected. Complications and free flap results were observed during follow-up

Results and Conclusions: 19 free flaps in 19 patients were studied. The most common indications were skin or bone defects caused by trauma (7 patients), tumor (5 patients) and congenital pseudarthrosis of the tibia (3 patients). The most indicated flap was vascularized fibular flap in 8 patients, followed by anterolateral thigh flap in 4 patients. Complications were observed in 4 patients and were: one dehiscence, one re-exploration of anastomosis with resolution of thrombosis and two cases of thrombosis of microanastomosis with avascular fibular flap. Of these two cases, one fibula was maintained avascular and the second case was submitted to trans-femoral amputation. 18 patients could preserve their limbs and in one case a toe-to-hand transfer was successfully performed.

Free flaps in children are safe and indications are restricted to precise indications of providing alternative to amputations and improving the function of patients.