Efficacy of free flaps for pediatric trauma patients in an adult trauma center.


:Although many trauma centers are primarily "adult-oriented," the presentation of unusual life- or limb-threatening wounds in children occasionally have mandated urgent microvascular tissue transfer for salvage. For these rare instances, should a microsurgical team accustomed to dealing with adult trauma patients even attempt to meet such a specialized challenge? A retrospective analysis of all free flaps performed by the author's team in trauma patients from 1984 to 1993, revealed only 10 pediatric patients who had had 11 separate free flaps. Their ultimate success rate was 90.9 percent--statistically the same rate (87.0 percent) as for 93 adult free flaps. The majority of these pediatric flaps were for urgent coverage of the lower extremity and they were all successful, eliminating any need for traditional pedicled flaps during the same time period. Improvement in technical expertise and judgment seemed to be more important factors than actual chronological age in determining free-flap success in general, and in children in particular. Therefore, free flaps in the pediatric population can be appropriately performed in an adult trauma center.


J Reconstr Microsurg


Hallock GG




Has Abstract


1995-05-01 00:00:00












  • Thoracoumbilical flap: experience with 33 cases.

    abstract::From August 1996 to June 2000, 33 free thoracoumbilical flaps were transferred to reconstruct a variety of soft-tissue defects. The size of the flaps ranged from 10 to 40 cm in length and 8 to 25 cm in width. The blood supply to the skin island came from the largest periumbilical perforator of the deep inferior epigas...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章


    authors: Zhang XQ,Wang SD,Fan QY,Mao BA,Zhou Y,Zhang MH

    更新日期:2004-02-01 00:00:00

  • Nerve regeneration in rat composite-tissue allografts.

    abstract::Reinnervation of composite-tissue allografts was examined in a rat hind-limb transplant model under Cyclosporin A (CyA) immunosuppression. Two groups of animals were studied. Group 1 consisted of 10 composite-tissue allografts using inbred Fisher rats (F344) as recipients and inbred Lewis rats (LEW) as donors. Recipie...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章


    authors: Maeda N,Ishiguro N,Inoue G,Miura T,Sugimura K

    更新日期:1991-10-01 00:00:00

  • Effects of late loss of arterial inflow on free flap survival.

    abstract::Greater than 80 percent of free flap thromboses have been shown to occur within the first three postoperative days, warranting immediate re-exploration and restoration of adequate vessel patency. The infrequency of thromboses beyond this period is reflected in the lack of reported cases in the literature and the absen...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章


    authors: Salgado CJ,Smith A,Kim S,Higgins J,Behnam A,Herrera HR,Serletti JM

    更新日期:2002-10-01 00:00:00

  • Short-term response of a skeletal growth plate to heterotopic microvascular transfer.

    abstract::The capacity of the epiphyseal growth cartilage from the dog fibula to retain its growth potential after heterotopic transfer to a distal radial defect was investigated and compared to orthotopically transferred controls. Autoradiographs of the physes cultured in 3H-thymidine indicated continued proliferation of the g...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章


    authors: Nettelblad H,Randolph MA,Weiland AJ

    更新日期:1985-01-01 00:00:00

  • A case of degloving injury of the whole hand reconstructed by a combination of distant flaps comprising an anterolateral thigh flap and a groin flap.

    abstract::A case of degloving injury of the whole hand reconstructed by a combination of an anterolateral thigh (ALT) flap and a groin flap applied as a pedicled distant flap was reported. Despite complications of congestion of the ALT flap and superficial infection, both flaps were severed at 4 weeks after transplantation, and...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章


    authors: Senda H,Muro H,Terada S,Okamoto H

    更新日期:2011-06-01 00:00:00

  • Medium- and Large-Sized Autologous Breast Reconstruction using a Fleur-de-lys Profunda Femoris Artery Perforator Flap Design: A Report Comparing Results with the Horizontal Profunda Femoris Artery Perforator Flap.

    abstract:BACKGROUND: The volume of the profunda femoris artery perforator (PAP) flap limits its indications to small- and medium-sized breast reconstructions after modified radical mastectomy for cancer. We report a modified PAP flap design, including not only a vertical extension that increases its volume but also the skin sur...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章


    authors: Hunsinger V,Lhuaire M,Haddad K,Wirz FS,Abedalthaqafi S,Obadia D,Derder M,Marchac A,Benjoar MD,Hivelin M,Lantieri L

    更新日期:2019-01-01 00:00:00

  • Does Postoperative Anticoagulation Therapy Lead to a Higher Success Rate for Microvascular Free-Tissue Transfer in the Head and Neck? A Systematic Review and Meta-Analysis.

    abstract:BACKGROUND: Due to limited evidence, it is unclear whether postoperative anticoagulation therapy may lead to higher success rates for microvascular free-flap surgery in the head and neck. This review evaluated whether postoperative anticoagulation therapy can lead to a better result in head and neck reconstruction. ME...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章,meta分析,评审


    authors: Liu J,Shi Q,Yang S,Liu B,Guo B,Xu J

    更新日期:2018-02-01 00:00:00

  • Effect of systemic piracetam treatment on flap survival and vascular endothelial growth factor expression after ischemia-reperfusion injury.

    abstract::The effects of piracetam on flap survival, ischemia-reperfusion (I/R) injury, and vascular endothelial growth factor (VEGF) expression were evaluated in this study. Unipedicled epigastric flap model was used in 36 rats and was evaluated within 4 groups. The flap was elevated and untreated in Group 1. Postoperative pir...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章


    authors: Tuncer S,Ayhan S,Findikcioglu K,Ergun H,Tuncer I

    更新日期:2011-09-01 00:00:00

  • Sensory reconstruction in sensate radial forearm flap transfer.

    abstract::The authors treated 14 patients (13 men and one woman), using a sensate radial forearm flap. Their ages at operation ranged from 27 to 67 years (mean: 52 years). Preoperative conditions were amputations in 10 cases, degloving injury in three, and crush injury in one. Reconstructive sites involved the thumb in nine cas...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章


    authors: Yamauchi T,Yajima H,Kizaki K,Kobata Y,Fukui A,Tamai S

    更新日期:2000-11-01 00:00:00

  • Preclinical efficacy of slow-release bFGF in ischemia-reperfusion injury in a Dorsal Island skin flap model.

    abstract::The effect of slow-release basic fibroblast growth factor (bFGF) on ischemia-reperfusion injury was examined using an island skin flap model in rats. Paired rectangular island skin flaps were elevated on the dorsum of 30 Fischer rats. The flaps were subjected to 6 hours of ischemia. Before reperfusion the flaps were i...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章


    authors: Wang Y,Orbay H,Huang C,Tobita M,Hyakusoku H,Myamoto M,Tabata Y,Mizuno H

    更新日期:2013-06-01 00:00:00

  • Operative technique to harvest an arterial flap from the posterolateral calf region: how can we elevate a lateral gastrocnemius perforating artery flap safely?

    abstract::The posterior calf region is a useful donor site for skin or composite flaps including muscle and/or nerves. We reported the first clinical use of the lateral gastrocnemius perforating artery flap including a vascularized sural nerve in 2003. This flap was elevated based on a perforator arising from the lateral head o...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章


    authors: Kashiwa K,Kobayashi S,Tono H,Ogino K,Kimura H

    更新日期:2008-01-01 00:00:00

  • Enhanced reinnervation of the paralyzed orbicularis oculi muscle after insulin-like growth factor-I (IGF-I) delivery to a nerve graft.

    abstract::Facial paralysis (FP) remains today one of the most disturbing cranial nerve disorders. The present study utilized the rat model of FP and examined a dual approach of combining the current microsurgical treatment of cross-facial nerve graft (CFNG) with local administration of insulin-like growth factor-I (IGF-I). The ...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章


    authors: Thanos PK,Tiangco DA,Terzis JK

    更新日期:2001-07-01 00:00:00

  • The relationship of functional return to varying methods of nerve repair.

    abstract::This experimental study correlated varying methods of nerve repair with the degree of functional return using the rat sciatic nerve as a model. Six groups of adult male Sprague-Dawley rats (300 to 350 g) had their left sciatic nerve crushed (Group 1), transected and not repaired (Group 6), or transected and repaired u...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章


    authors: Buehler MJ,Seaber AV,Urbaniak JR

    更新日期:1990-01-01 00:00:00

  • Extra and Intramuscular Distribution of the Thoracodorsal Nerve with Regard to Nerve Reconstruction Surgeries.

    abstract::Background The lateral branch of the thoracodorsal nerve (LBTN) is used for nerve transfer in facial, musculocutaneous, axillary nerve injuries and for irreparable C5, C6 spinal nerve lesions and accessory nerve defects. For a successful surgical outcome, the nerve to be used in nerve transfer should be of adequate le...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章


    authors: Malalasekera A,Beneragama T,Kanesu S,Sahathevan V,Jayasekara R

    更新日期:2016-06-01 00:00:00

  • Standardized templates for shaping the fibula free flap in mandible reconstruction.

    abstract::Conversion of the straight fibula bone flap into the parabolic mandible shape can be performed using customized acrylic templates made from a 1:1 mandible computed tomography scan and lateral cephalogram. The premise of the current study is to objectively quantify the variability in a series of acrylic templates used ...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章


    authors: Matros E,Santamaria E,Cordeiro PG

    更新日期:2013-11-01 00:00:00

  • Forequarter amputation wound coverage with an ipsilateral, lymphedematous, circumferential forearm fasciocutaneous free flap in patients undergoing palliative shoulder-girdle tumor resection.

    abstract::Closure of massive soft-tissue defects in patients undergoing forequarter amputation for shoulder-girdle tumors may present a daunting challenge. This report describes two patients whose forequarter amputations were closed using ipsilateral, lymphedematous, circumferential forearm fasciocutaneous free flaps. ...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章


    authors: Zachary LS,Gottlieb LJ,Simon M,Ferguson MK,Calkins E

    更新日期:1993-03-01 00:00:00

  • Early and long-term evaluation of perfusion changes in free DIEP-flaps for breast reconstruction via IC-view and duplex ultrasound: autonomous or peripheral perfusion?

    abstract::Controversy surrounds the question whether free flaps remain dependent for blood supply on their vascular pedicle or if there is an autonomization by neovascularization from the surrounding wound bed. This becomes important when flap shaping or repositioning are performed. Our study involved 23 patients who received a...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章


    authors: Heitland AS,Markowicz MP,Koellensperger E,Schoth F,Pallua N

    更新日期:2009-02-01 00:00:00

  • Intraoperative decision making by electrophysiological detection of the origin of thoracodorsal nerve in the C7 nerve root transfer procedure.

    abstract::The objective of this article is to discuss the significance of predicting the injury degree of the thoracodorsal nerve by intraoperative electrophysiological examination in the C7 nerve root transfer for brachial plexus injury. Each trunk of the brachial plexus followed by each bundle of C7 was stimulated before the ...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章


    authors: Lu W,Xu J,Wang D

    更新日期:2011-01-01 00:00:00

  • Anatomic imaging of abdominal perforator flaps without ionizing radiation: seeing is believing with magnetic resonance imaging angiography.

    abstract::The tremendous variability of the inferior epigastric arterial system makes accurate imaging of the vasculature of the anterior abdominal wall an essential component of optimal perforator selection. Preoperative imaging of the abdominal vasculature allows for preoperative perforator selection, resulting in improved op...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章


    authors: Greenspun D,Vasile J,Levine JL,Erhard H,Studinger R,Chernyak V,Newman T,Prince M,Allen RJ

    更新日期:2010-01-01 00:00:00

  • Indocyanine Green Lymphography, Lymphoscintigraphy, and Genetic Analysis in Nonsyndromic Primary Lymphedema: The Distal Dermal Backflow Grading System and the Print Sign.

    abstract:BACKGROUND: Investigating correlations between clinical, instrumental, and genetic features of primary lymphedema (PL) with the aim to facilitate the diagnosis, the staging, and the management of this subgroup of patients. METHODS: A prospective observational study was conducted from September 2016 to May 2018, includ...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章


    authors: Mangialardi ML,Lorenzano V,Pagliara D,Visconti G,Gentileschi S,Salgarello M

    更新日期:2020-03-01 00:00:00

  • FK506 and nerve regeneration: past, present, and future.

    abstract::Promoting neurological recovery requires strategies that simultaneously provide protection to injured neurons and increase the numbers of neurons that extend axons while inducing more rapid and extensive axon regeneration across long nerve gaps. An agent that facilitates the speed and success of reinnervation will hav...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章,评审


    authors: Konofaos P,Terzis JK

    更新日期:2013-03-01 00:00:00

  • Successful correction of severe contracture of the palm using arterialized venous flaps.

    abstract::Severe contracture of the palm causes great difficulty in the performance of the tasks required in daily life. Resurfacing with skin grafts may be sufficient for treating mild and small contractures; but severe and extensive contractures involving the joints, tendons, and neurovascular bundles should be covered with t...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章


    authors: Nakazawa H,Nozaki M,Kikuchi Y,Honda T,Isago T

    更新日期:2004-10-01 00:00:00

  • First successful lower-extremity transplantation: technique and functional result.

    abstract::Composite tissue transplantation has emerged as a viable alternative to prosthetics and complex reconstructive surgery. Thus far it is reserved for cases which cannot be effectively reconstructed and where it offers some benefits over prostheses. It has been used in the upper extremity with encouraging results and, mo...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章


    authors: Zuker RM,Redett R,Alman B,Coles JG,Timoney N,Ein SH

    更新日期:2006-05-01 00:00:00

  • Endoneural and epineural blood flow evaluation with free vascularized and conventional nerve grafts in the canine.

    abstract::Blood flow distribution in conventional and vascularized canine nerve grafts was analyzed. Between 4 and 6 days after operation, blood flow at both the fascicular (endoneural) and the nerve-sheath (epineural) levels was significantly greater in the nonvascularized nerve grafts than in their vascularized counterparts (...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章


    authors: Daly PJ,Wood MB

    更新日期:1985-10-01 00:00:00

  • Impact of Obesity on Outcomes in Breast Reconstruction: A Systematic Review and Meta-Analysis.

    abstract:BACKGROUND: Increased rates of both breast cancer and obesity have resulted in more obese women seeking breast reconstruction. Studies demonstrate that these women are at increased risk for perioperative complications. A systematic review was conducted to assess the outcomes in obese women who underwent breast reconstr...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章,meta分析,评审


    authors: Panayi AC,Agha RA,Sieber BA,Orgill DP

    更新日期:2018-06-01 00:00:00

  • Decrease of Thrombosis in Microsurgical Anastomoses: The Use of Intraoperative Pure Intraluminal Unfractionated Heparin.

    abstract:BACKGROUND: Unfractionated heparin has anticoagulant properties by catalyzing antithrombin III, which inactivates coagulation enzymes. Used in microsurgery, it would prevent the occurrence of thrombosis during microsurgical anastomoses. The objective of this study was to evaluate the role of intraoperative irrigation o...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章


    authors: Ramelli E,Durry A,Ruffenach L,Bruant-Rodier C,Bodin F

    更新日期:2020-01-01 00:00:00

  • Nerve repair at different angles of attachment: experiment in rats.

    abstract::Sixteen rats underwent two procedures to test the efficacy of oblique vs. transverse nerve repair. On the left, the peroneal nerve was transected at an oblique angle (30-degree) with subsequent oblique end-to-end repair performed. On the right, the peroneal nerve was transected at a transverse angle (90-degree) with s...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章


    authors: Yan YH,Yan JG,Sanger JR,Zhang LL,Riley DA,Matloub HS

    更新日期:2002-11-01 00:00:00

  • Targeted Muscle Reinnervation: Outcomes in Treating Chronic Pain Secondary to Extremity Amputation and Phantom Limb Syndrome.

    abstract:BACKGROUND: Secondary to vascular disease, oncological resection, or devastating trauma, lower extremity amputations are performed globally at a yearly rate exceeding 1 million patients. Three-quarters of these patients will develop chronic pain or phantom pain, which presents a functional limitation for prosthetic use...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章


    authors: McNamara CT,Iorio ML

    更新日期:2020-05-01 00:00:00

  • Reporting Practices on Immunosuppression and Rejection Management in Face Transplantation: A Systematic Review.

    abstract:BACKGROUND: Face transplantation is a demanding operation requiring complex planning and expert technical performance. While the documentation of successes of the first transplants is impressive, there are lacunae in reporting of institutional protocols for other critical operation components, namely, immunosuppression...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章


    authors: Daneshgaran G,Stern CS,Garfein ES

    更新日期:2019-11-01 00:00:00

  • Occasions for multiple flaps in lower-limb reconstructions: once is sometimes not enough.

    abstract::A retrospective review of 11 patients with complex and massive lower-limb defects requiring multiple transfers and/or regional muscle flaps for closure, found that microvascular transfers achieved final wound closure, either alone or in concert with local flaps, in all but one case. A local flap alone was not sufficie...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章


    authors: Isenberg JS

    更新日期:1998-04-01 00:00:00