Abir MANNI, Yacine ZOUIRECH, Yassine LEMZABI, Nawfal FEJJAL
Turkish Journal of Plastic Surgery - 2026;34(1):21-27
Pediatric hand skin defects (HSDs) may result in long-term functional, growth-related, and esthetic impairment. In resource-limited settings, a simple and structured algorithm may help standardize reconstructive decision-making. A retrospective review was conducted of patients under 17 years treated surgically for HSDs between 2014 and 2022 in a tertiary pediatric plastic surgery and burns unit. Management followed a structured algorithm based on defect size, depth, and exposure of critical structures. Forty-six patients (54 hands) were included, with a mean age of 9 +/- 4 years; 63% were male. Burns were the predominant etiology (74%). A total of 71 surgical procedures were performed, most commonly skin grafting (41%), contracture release (24%), and local or regional flap reconstruction (16%). The overall complication rate was 7.0%. At final follow-up, acceptable functional and esthetic outcomes were achieved in more than 80% of cases, good-to-excellent postoperative ROM was observed in 88% of hands. A defect-based algorithm for pediatric HSDs provides favorable functional and esthetic outcomes with a low complication rate and appears applicable across a range of clinical and resource settings.
