Free flaps for pediatric facial reconstruction: the Maryland experience

Introduction: The advances of microsurgical techniques have made the use of free tissue transfer in the pediatric population a viable reconstructive option.

Objective: The purpose of this abstract is to review the use of free tissue microvascular transfer in the pediatric population with head and neck defects at the University of Maryland, Department of OMS.

Patients and methods: A retrospective chart audit of the past 10 years was performed. All patients 18 years and younger who received a microvascular reconstruction for a head and neck defect were included in this review.

Results: There were 12 patients requiring 13 flaps. One patient with a gunshot injury required 2 flaps. The average age at surgery was 15 years (range 12–18).

The reasons for reconstruction were as follows: benign tumor (9), malignant tumor (2), and trauma (2). The defects were mostly osseous mandible (10) with only 3 soft tissue reconstructions. Flap selection included 10 fibulas (w or w/o skin), 2 radial forearms, and 1 anterolateral thigh. There were no immediate flap complications and one minor wound complication. Average length of hospital stay was 7 days (5–10).

Conclusion: In many ways children constitute an ideal patient population for microsurgical reconstruction despite rare indications. In general the pediatric patient has pristine anatomy, no complications of chronic disease, as well as an excellent healing capacity. Consideration should be given however to future growth at both the recipient and donor site as well as tissue available in the skeletally immature patient.

Conflict of interest: None declared.

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Jan 27, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Free flaps for pediatric facial reconstruction: the Maryland experience
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