title: Pediatric free tissue transfer: an evaluation of 99 cases.
abstract: OBJECTIVE
  To evaluate the results of free tissue transfers in children who undergo reconstructive surgery.
  
  
  METHODS
  Case series chart review. Mean follow-up longer than 2 years.
  
  
  METHODS
  Two tertiary care pediatric hospitals.
  
  
  METHODS
  Consecutive sample of 99 children.
  
  
  METHODS
  Free tissue transfers for reconstruction of a variety of defects.
  
  
  METHODS
  Indications, operations, complications, survival.
  
  
  RESULTS
  The most common indications were for restoration of muscle function and for difficulties with soft-tissue coverage. Multiple donor sites were used, with the gracilis muscle, fibula, latissimus dorsi and groin flaps predominating. The overall survival rate was 99.0%. Complications were common, with an overall rate of 59.6%; most were graded as minor or moderate.
  
  
  CONCLUSIONS
  Meticulous planning is paramount in achieving a successful outcome. Complications are common but do not include vascular spasm. Free tissue transfers can be successfully completed in small children despite the dimensions of the tissues.
authors.affiliation: Division of Plastic Surgery, Hospital for Sick Children, Toronto, Ont.
authors.forename: H M
authors.initials: HM
authors.lastname: Clarke
authors.forename: J
authors.initials: J
authors.lastname: Upton
authors.forename: R M
authors.initials: RM
authors.lastname: Zuker
authors.forename: R T
authors.initials: RT
authors.lastname: Manktelow
mesh_terms: D000293:Adolescent; D000328:Adult; D001132:Arm / Q000601:surgery; D016025:Bone Transplantation / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005069:Evaluation Studies as Topic; D005145:Face / Q000601:surgery; D005500:Follow-Up Studies; D005542:Forearm / Q000601:surgery; D006225:Hand / Q000601:surgery; D006801:Humans; D007223:Infant; D007866:Leg / Q000601:surgery; D009132:Muscles / Q000637:transplantation; D010348:Patient Care Team; D012086:Reoperation; D013524:Surgical Flaps / Q000009:adverse effects / Q000379:methods; D014022:Tissue Survival; D016378:Tissue Transplantation / Q000009:adverse effects / Q000379:methods