微血管游离组织转移是头颈部肿块切除后手术部位重建的广泛使用的技术。虽然它常用于成人，但儿童头颈癌的罕见性使得游离皮瓣重建在该人群​​中相对较少。游离皮瓣重建可以覆盖因广泛切除而可能导致的大缺损，以避免儿科患者接受初级放射治疗。我们介绍了两个使用游离皮瓣重建的儿科肿瘤病例。第一个患者是一名 4 岁男性，出现快速扩大的舌头病变，被诊断为双相滑膜肉瘤。切除肿块，并放置前臂桡侧游离皮瓣。第二名患者是一名 9 岁男性，出现下颌疼痛和下颌肿块。活检证实诊断为尤文肉瘤。该患者最初接受化疗，然后进行手术切除并放置腓骨骨皮瓣。两名患者术后 5 年均无病。每位患者均通过游离皮瓣重建完全切除原发肿瘤，无需放疗。随着医学的进步能够更好地评估清晰的切缘，从而导致更大的切除缺陷，游离组织移植为儿科人群提供了一种有用的重建选择。2024 转化儿科。版权所有。

Microvascular free-tissue transfer is a widely used technique for surgical site reconstruction following head and neck mass resection. While it is commonly used in adults, the rarity of head and neck cancers in children makes free flap reconstruction relatively rare in this population. Free flap reconstruction allows for coverage of large defects which may result from wide resections performed to avoid exposing pediatric patients to primary radiotherapy.We present two pediatric oncologic cases using free flap reconstruction. The first, a 4-year-old male, presented with a rapidly enlarging tongue lesion that was diagnosed as a biphasic synovial sarcoma. The mass was resected, and a radial forearm free flap was placed. The second, a 9-year-old male, presented with jaw pain and a mandibular mass. Biopsy confirmed a diagnosis of Ewing sarcoma. The patient was treated initially with chemotherapy, followed by surgical resection and placement of an osteocutaneous fibular free flap. Both patients are disease-free 5 years post-operation.In each patient, complete resection of the primary tumor was performed eliminating the need for radiotherapy with utilization of free flap reconstruction. As advances in medicine enable better evaluation of clear margins resulting in larger resection defects, free tissue transfer provides a useful reconstructive option in the pediatric population.2024 Translational Pediatrics. All rights reserved.