Reconstructive Strategies and Wound Management in Severe Pediatric Injuries of the Lower Limbs: Lessons From a Case Report

Abstract: Introduction. Severe injuries to lower limbs occurring in the pediatric population represent a unique challenge for reconstructive surgeons. The need for optimal anatomical repair and functional recovery must take into consideration several variables that may remarkably affect overall outcomes, length of hospitalization, and quality of life during recovery. The most appropriate therapeutic strategy should be based on the accurate planning of the least-invasive wound management, in terms of pain or other symptoms, local morbidity, and systemic response. Materials and Methods. With the purpose of discussing these issues, the authors present an illustrative case report of a 5-year-old child affected by a severe traumatic injury to the left leg complicated by wound hemorrhage as the result of a car accident. The vast loss of soft tissue was successfully treated by promptly staged surgical intervention and repair by using a regenerative dermal template. Results. Effective postoperative wound management and good compliance of the patient during hospitalization allowed for a substantial absence of complications and effective treatment of relevant symptoms. Conclusion. Excellent functional recovery at 12-month follow-up was achieved, as well as a good overall quality of life.