Pediatric Free Tissue Transfers: Clinical Experience

Deniz F. A., Apaydın A. C., Kastamoni Başkan M., Çeçen S., Özgenel G. Y., Akın S.

4th International Microsurgery Meeting Izmir, İzmir, Turkey, 26 - 28 September 2025, pp.43-44, (Summary Text)

  • Publication Type: Conference Paper / Summary Text
  • City: İzmir
  • Country: Turkey
  • Page Numbers: pp.43-44
  • Bursa Uludag University Affiliated: Yes

Abstract

Introduction: Pediatric reconstructive surgery differs significantly from adults due to small vessel diameters, a tendency for vasospasm, anesthesia challenges, and difficulties in postoperative care. These factors make the planning and execution of free tissue transfers more complex in children.

Objective: The aim of this study was to evaluate the clinical characteristics, etiologies, flap types, and early outcomes of pediatric free flap cases performed in our clinic over the past three years. Materials and Methods: A retrospective analysis was conducted on 9 patients aged 16 years or younger who underwent free tissue transfer between 2022 and 2025 in a single center. Demographic data, defect locations, etiologies, types of free flaps performed, and early flap survival rates were recorded.

Results: The mean age was 8.9 years (range 5–16), with 5 males and 4 females. Trauma was the most common etiology (55.6%), followed by tumor in 2 patients and Volkmann’s ischemic contracture in 2 patients. Defect locations included the upper extremity (4), lower extremity (4), and head and neck (1). The flaps performed were ALT (2), gracilis (2), SLGP (2), fibula (1), AMT (1), and SCIP (1). Overall early flap survival was 78%, with flap loss occurring in 2 cases. Losses were more common in trauma patients, whereas no flap loss was observed in tumor or Volkmann’s contracture cases.

Conclusion: Pediatric free tissue transfers can be performed safely with appropriate indication, meticulous preoperative planning, and an experienced microsurgical team. Our findings demonstrate that trauma is the most frequent indication, upper and lower extremity defects occur at similar rates, and head and neck reconstructions represent a smaller subgroup. These results highlight the importance of structured protocols and multidisciplinary collaboration in achieving successful outcomes in pediatric free flap surgery.