Systematic Review of Free Tissue Transfer Used in Pediatric Lower Extremity Injuries

Mehul Thakkar, MBBS; Bartlomiej Bednarz, MBBS, MA(Cantab)


ePlasty. 2021;21:e2 

In This Article


The aim of this review is to analyze the recently published literature regarding the different types of free tissue transfer used in pediatric lower-limb trauma, trends, flap success rates, and the anatomical location of reconstruction.

The advancement and high success rates of microsurgical free tissue transfer has have enabled large soft-tissue defects to be covered using a number of different types of autologous tissue. The ability to cover large soft-tissue defects with free tissue transfer has been extremely useful in limb salvage procedures resulting from trauma or even malignancies such as sarcoma.

Pediatric lower-limb trauma (PLLT) with extensive soft-tissue loss such as Gustilo-Anderson IIIB fractures poses a great challenge to the reconstructive surgeon due to concerns about vessel diameter size (both donor and recipient), increased vessel vasospasm potential, donor site availability, donor site morbidity, and long-term implications such as growth restriction and psychological impact. Despite these concerns, there is a growing consensus among reconstructive microsurgeons that pediatric free tissue transfer is a viable option with high success rates.[1]

The aim of this review was to analyze the recent published literature regarding the types of free tissue transfer used in PLLT, the recent trend, success rates, and the location of soft-tissue reconstruction in the lower limb.