title: Distally based perforator-plus sural fasciocutaneous flap for soft-tissue reconstruction of the distal lower leg, ankle, and foot: comparison between pediatric and adult patients.
abstract: There are no large series comparing the distally based perforator-plus sural fasciocutaneous flap used in pediatric and adult populations. The flaps were divided into two groups: the children (patient's age<14 years) group (n=53) and the adults (patient's age ≥ 18 years) group (n=148). We compared flap-viability-related complications and their potential risk factors. In the patients with at least 12-month postoperative follow-up, the reconstruction outcomes, donor-site morbidities, and transitory and permanent swelling of the affected lower limb were compared. Partial necrosis, marginal necrosis, and overall complication rates were 13.2, 3.8, and 17.0% in the pediatric group, and 12.2, 1.4, and 13.6% in the adult group, respectively; the differences were not statistically significant (p>0.05). Incidences of hypertrophic scar and pruritus at the donor site were significantly higher, while incidence of transitory swelling of the affected lower limb was significantly lower in the pediatric group. This flap in children is similar to that in adults in the reliability.
authors.affiliation: Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China.
authors.forename: Jian-Wei
authors.initials: JW
authors.lastname: Wei
authors.affiliation: Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China.
authors.forename: Jiang-Dong
authors.initials: JD
authors.lastname: Ni
authors.affiliation: Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China.
authors.forename: Zhong-Gen
authors.initials: ZG
authors.lastname: Dong
authors.affiliation: Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China.
authors.forename: Li-Hong
authors.initials: LH
authors.lastname: Liu
authors.affiliation: Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China.
authors.forename: Zhao-Biao
authors.initials: ZB
authors.lastname: Luo
authors.affiliation: Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zheng
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000842:Ankle / Q000601:surgery; D002648:Child; D005260:Female; D005528:Foot / Q000601:surgery; D058752:Free Tissue Flaps; D006085:Graft Survival; D006801:Humans; D007866:Leg / Q000601:surgery; D008297:Male; D010019:Osteomyelitis / Q000150:complications / Q000601:surgery*; D061525:Perforator Flap; D019651:Plastic Surgery Procedures / Q000379:methods*; D015203:Reproducibility of Results; D016038:Skin Transplantation; D017695:Soft Tissue Injuries / Q000150:complications / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000150:complications / Q000601:surgery*; D013497:Sural Nerve / Q000637:transplantation