MICROSURGERY IN CHILDREN

Advances in microsurgical techniques have permitted replantation and r econstructive procedures to restore amputated or injured parts with a high degree of success in children. Despite this progress, some techni cal concerns remain. During a 15-year period, replantations were done in 53 children with major limb (18), hand (10), or digit (25) amputati ons. Even in patients with crush or avulsion injuries, the results sug gest that replantation procedures are justified considering the superi or recuperative ability in children. Free tissue transfer was used for reconstructive procedures in 26 children, including free flaps, vascu larized bone transfers, nerve grafts, and toe-to-thumb transfers. The microsurgical success rate was 86.8% for replantation procedures and 9 6% for reconstructive procedures. Although the technical aspects and o utcome of replantation attempts still differ between adults and childr en, there appears to be little difference in free tissue transfer. Thu s, most replantation and reconstructive procedures can be attempted wi th a high possibility of success in children.