Coverage of large skin defects of the pediatric upper extremity

Since the 1970s and 1980s, the use of flaps for soft tissue repair in child ren has followed the developments made in the reconstructive surgery of adu lts. The increased use of vascularized flaps has been allowed by the develo pment of microsurgical techniques and by deeper anatomic study of supplies of blood, skin, and muscle. No difficulty was found in making very fine dis sections on children under a microscope. The cause of large skin defects in the upper limb involves different pathologies than trauma, infections, tum ors, and congenital problems. New vascularized pedicled flaps are constantl y being developed, increasing the armamentarium of the physician and allowi ng for better indications.