Many challenges have been described by microsurgeons in paediatric free flaps. With the advancement in microsurgical expertise, it is now possible to achieve excellent results. We present a case of a female child with car-tyre friction injury of bilateral feet with associated extradural haemorrhage who underwent emergency bilateral anterolateral thigh flap. A secondary tendon reconstruction of the left foot was performed at 6 months. No complications were observed in the postoperative period after both procedures and good functional recovery was achieved at 1 year follow-up. The problems unique to this case were the presence of head injury and bilateral extremity injury in the paediatric patient. The technical details of planning, execution, difficulties and recommendations to minimise the risk in such cases are discussed. To the best of our knowledge, this is the only case report of bilateral lower limb paediatric emergency free flap with associated head injury.
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http://dx.doi.org/10.1136/bcr-2023-257181 | DOI Listing |
Microsurgery
January 2025
Plastic, Reconstructive, and Aesthetic Surgery Unit, Nantes University Hospital, Nantes, France.
Introduction: Reconstructing large bone defects for lower limb salvage in the pediatric population remains challenging due to complex oncological or septic issues, limited surgical options, and lengthy procedures prone to complications. The vascularized double-barreled fibula free flap is pivotal for reconstructing large bones. In this article, we report our experience with this technique in the surgical management of pediatric tibial bone defects.
View Article and Find Full Text PDFFront Oncol
January 2025
Department of Anesthesiology, Shenshan Medical Central, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Shanwei, China.
Background: Head and neck free flap reconstruction presents challenges in managing intraoperative circulation, potentially leading to prolonged length of stay (PLOS). Limited research exists on the associations between intraoperative circulation and PLOS given the difficulty of manual quantification of intraoperative circulation time-series data. Therefore, this study aimed to quantify intraoperative circulation data and investigate its association with PLOS after free flap reconstruction utilizing machine learning algorithms.
View Article and Find Full Text PDFMicrosurgery
January 2025
Service de Chirurgie Plastique et Reconstructrice, Hôpital européen Georges-Pompidou, Paris, France.
Objective: The optimal method for maintaining intraoperative blood pressure during microsurgical procedures remains controversial. While intravenous fluid administration is essential, overfilling can lead to complications. Vasopressor agents are used cautiously due to their vasoconstrictive effects, which could potentially lead to flap failure.
View Article and Find Full Text PDFBr J Oral Maxillofac Surg
December 2024
Head and Neck Surgery, Leicester Royal Infirmary, United Kingdom. Electronic address:
Int J Surg Case Rep
January 2025
Department of Plastic and Breast Surgery, Aarhus University Hospital, Denmark.
Introduction: Necrotising soft tissue infection (NSTI) is an exceptionally dangerous infectious disease targeting soft tissues with high mortality as well as morbidity. The aim of reconstructive surgery after initial debridement is to maintain function as well as to achieve a satisfactory cosmetic result.
Presentation Of Case: A 50-year-old male presented with necrotising soft tissue infection on the thorax and left upper arm following mastectomy for breast cancer.
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