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Gimenez et al. Plast Aesthet Res 2022;9:28 Plastic and
DOI: 10.20517/2347-9264.2021.129
Aesthetic Research

Review Open Access

Soft tissue reconstruction of the lower extremity in
the pediatric population

1,2
1
Alejandro R. Gimenez , Andrew M. Ferry , William C. Pederson 1,2
1
Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA.
2
Division of Plastic Surgery, Department of Surgery, Texas Children’s Hospital, Houston, TX 77030, USA.
Correspondence to: Dr. Alejandro R. Gimenez, Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor
College of Medicine, 6701 Fannin St, Suite 610.00, Houston, TX 77030, USA. E-mail: alejandro.gimenez@bcm.edu
How to cite this article: Gimenez AR, Ferry AM, Pederson WC. Soft tissue reconstruction of the lower extremity in the pediatric
population. Plast Aesthet Res 2022;9:28. https://dx.doi.org/10.20517/2347-9264.2021.129
Received: 1 Dec 2021 First Decision: 24 Dec 2021 Revised: 5 Jan 2022 Accepted: 7 Mar 2022 Published: 9 Apr 2022

Academic Editors: Matthew L Iorio, Marten Basta Copy Editor: Xi-Jun Chen Production Editor: Xi-Jun Chen

Abstract
Lower extremity defects are a source of significant functional and psychosocial morbidity for pediatric patients and
require complex reconstructions to restore form and function. The advent of microsurgical reconstruction along
with advances in wound care techniques and technologies have empowered reconstructive surgeons to perform
limb salvage surgery in patients that would traditionally require amputation; however, the indications for
performing reconstructive surgery for complicated cases are not ironclad. While this is the case, applying the
principles of lower extremity reconstruction in adults to the pediatric population is often sufficient to achieve a
satisfactory outcome. This overview discusses the evaluation and management of soft tissue defects of the leg in
pediatric patients.

Keywords: Plastic surgery, orthoplastic, pediatric, microsurgery, reconstruction, functional reconstruction

INTRODUCTION
Lower extremity defects cause significant functional and psychosocial morbidity in children and are a
considerable source of the financial burden for healthcare systems. These defects pose many challenges for
reconstructive surgeons given the technical demand required to successfully perform the reconstruction,
along with the need to consider functional, psychosocial, and aesthetic factors when developing the

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
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