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Pediatric microsurgery procedures possess various difficulties when compared with adults. However, both free tissue transfers and replantation of the amputated parts show remarkable success rates in children. The concerns of survival of the flaps and the amputated parts have shifted to the function of these in the adulthood. Several key points and hints allow successfull rates for both survival and function. We present a series of microsurgical procedures both free tissue transfers (12 patients) and digital replantations (13 patients). Free tissue transfers included toe-to-hand transfers in 5, latsissimus dorsi flaps in 4, fibular flaps in 4, and anterolateral thigh flaps in 2 patients. Thirteen patients involved 17 digital replantations. The survival rate was less in the replantation group (58.75%) than in the free tissue transfer group (93%). Both the functional and the cosmetic results were promising. The follow-up period was between 1 and 6 years (mean 37 months) for the free tissue transfer group and 1-5 years (mean 20 months) for the replantation group. The major technical difficulties include the age group of 0-2 years. Aside from these the high capacity of regeneration and the improved learning capacity increase the feasibility of the microsurgical procedures proceeded among children.

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