Coverage of large skin defects of the pediatric upper extremity

Since the 1970s and 1980s, the use of flaps for soft tissue repair in children has followed the developments made in the reconstructive surgery of adults. The increased use of vascularized flaps has been allowed by the development of microsurgical techniques and by deeper anatomic study of supplies of blood, skin, and muscle. No difficulty was found in making very fine dissections on children under a microscope. The cause of large skin defects in the upper limb involves different pathologies than trauma, infections, tumors, and congenital problems. New vascularized pedicled flaps are constantly being developed, increasing the armamentarium of the physician and allowing for better indications.