Use of thoracodorsal artery perforator flap for soft tissue reconstruction in children

Perforator free flap (PFF) is now performed with increasing frequency for soft tissue reconstruction in adults. When compared with conventional free skin flaps, PFFs are thinner and have less donor-site morbidity because only the skin is harvested. The advancement of the PFF design has spurred the identification of many skin flaps based on the perforator principle. Although PFFs are used in adults, most reconstructive surgeons still hesitate to perform PFFs in children. The main cause of concern is the perceived high failure rate related to the small diameter of children's perforator vessels. We present 4 consecutive cases of successful transfer of thoracodorsal artery perforator flap in children. We present our flap design and surgical technique to highlight the usefulness of this flap for reconstructing soft tissue defects in children.