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 PRISMA guideline on systematic reviews was adhered to as much as possible.[2] A literature search was conducted using the MEDLINE database through PubMed. The key words used were "Paediatric," "Pediatric," "Children," "Lower limb," "Lower extremity," "Leg," "Ankle," "Foot," "Free flap," "Flap," "Microsurgery," and "Free tissue transfer" in a 3-component search using the Boolean operators "OR" and "AND." The search was condensed to articles published in the last 5 years to include the most recent studies published. The titles were used to further narrow down the search, and abstracts of all subsequent studies retrieved were reviewed by the 2 authors; eligibility was determined using the following inclusion and exclusion criteria. Inclusion criteria included series of pediatric populations alone or where pediatric populations underwent subgroup analyses, case series of more than 2 patients, studies pertaining to soft-tissue coverage in traumatic lower-limb injuries using free tissue transfer among the cohort, and English language publications. Exclusion criteria included mixture of adult and pediatric population data with no pediatric subgroup analysis, single-series case reports, upper extremity reconstructions such as toe-to-digit transfers, and free tissue transfers for non–trauma-related lower-limb reconstructions.