Microsurgical reconstruction in children's burns.

There have been few reports on microsurgical procedures performed on children who have been left with disability and deformity as a result of burn injury. The reality is that whilst there are many children who could benefit from such procedures they do not have access to the resources that can provide them. Where these resources are available there has been a reluctance to use them partially due to a misconception that such procedures are technically challenging and carry significant risk. This paper presents a series of 21 children in whom 29 microsurgical procedures were performed. There were two failures but in all other cases there was significant improvements in the functional ability and/or the aesthetic appearance of the child. This series includes novel variations on the antero-lateral thigh flap; tissue engineering, dual flap harvest, size and age. Refinements of inset are described to prevent pin-cushioning and linear scar contracture. In selected cases microsurgical reconstruction can produce life long benefits, with minimal surgical and donor site morbidity.