title: Free deep inferior epigastric artery perforator flap for reconstruction of soft-tissue defects in extremities of children.
abstract: The deep inferior epigastric artery perforator (DIEP) flap has been a valuable tool in breast reconstruction, but seldom in extremity reconstruction. The aim of this report is to present our experience on the use of the DIEP flap for reconstruction of soft-tissue defects in the extremities of pediatric patients. From January 2007 to February 2011, 22 consecutive free DIEP flap transfers were performed for reconstruction of complex soft-tissue defects in the extremities of children with a mean age of 5.7 years old (ranging 2-10 years old). The flap design included transverse, oblique, and irregular DIEP flaps, containing one to three perforators in the flap. The flap size ranged from 7 × 4 cm to 18 × 17 cm. Primary donor-site closure was accomplished in all of patients. The postoperative course was uneventfully in most of cases. The venous congestion was observed in two cases. One case of venous congestion was caused by flap inset with tension. The other case with venous thrombosis ended with partial loss of the flap after salvage procedure. There was one total flap loss due to the arterial thrombosis. The flap survival rate was 95.5%. The mean follow-up was 12 months (ranging 6-36 months). All reconstructed extremities had satisfactory aesthetic and functional outcomes except two cases undergoing the secondary debulking procedures. The donor sites healed well in all cases without complications. Our experience showed that the free DIEP flap could be an alternative for reconstruction of soft-tissue defects in the extremities of children.
authors.affiliation: Department of Hand and Microsurgery, Xiangya Hospital of Central South University, Changsha, China.
authors.forename: Juyu
authors.initials: J
authors.lastname: Tang
authors.affiliation: Department of Orthopaedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.|Department of Plastic Surgery, University of Mississippi Medical Center, Jackson, MS.
authors.forename: Taolin
authors.initials: T
authors.lastname: Fang
authors.affiliation: Department of Hand and Microsurgery, Xiangya Hospital of Central South University, Changsha, China.
authors.forename: Dajiang
authors.initials: D
authors.lastname: Song
authors.affiliation: Department of Hand and Microsurgery, Xiangya Hospital of Central South University, Changsha, China.
authors.forename: Jieyu
authors.initials: J
authors.lastname: Liang
authors.affiliation: Department of Hand and Microsurgery, Xiangya Hospital of Central South University, Changsha, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Yu
authors.affiliation: Department of Hand and Microsurgery, Xiangya Hospital of Central South University, Changsha, China.
authors.forename: Congyang
authors.initials: C
authors.lastname: Wang
mesh_terms: D002648:Child; D002675:Child, Preschool; D019074:Epigastric Arteries / Q000637:transplantation*; D005121:Extremities / Q000293:injuries* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000098:blood supply / Q000637:transplantation*; D006085:Graft Survival; D006801:Humans; D008297:Male; D061525:Perforator Flap / Q000098:blood supply / Q000637:transplantation*; D019651:Plastic Surgery Procedures / Q000379:methods*; D017695:Soft Tissue Injuries / Q000601:surgery*; D016896:Treatment Outcome