Prophylactic fixation of donor site in radial forearm osteocutaneous free flaps using locking reconstruction plate augmented with mineral cement

Introduction. The radial forearm free flap has an important role in reconstruction of the oncologic defects in the region of head and neck. Objective. The aim was to present and evaluate clinical experience and results in the radial forearm free transfer for intraoral reconstructions after resections due to malignancies. Methods. This article illustrates the versatility and reliability of forearm single donor site in 21 patients with a variety of intraoral oncologic defects who underwent immediate (19 patients, 90.5%) or delayed (2 patients, 9.5%) reconstruction using free flaps from the radial forearm. Fascio-cutaneous flaps were used in patients with floor of the mouth (6 cases), buccal mucosa (5 cases), lip (1 case) and a retromolar triangle (2 cases) defects, or after hemiglossectomy (7 cases). In addition, the palmaris longus tendon was included with the flap in 2 patients that required oral sphincter reconstruction. Results. An overall success rate was 90.5%. Flap failures were detected in two (9.5%) patients, in one patient due to late ischemic necrosis, which appeared one week after the surgery, and in another patient due to venous congestion, which could not be salvaged after immediate re-exploration. Two patients required re-exploration due to vein thrombosis. The donor site healed uneventfully in all patients, except one, who had partial loss of skin graft. Conclusion. The radial forearm free flap is, due to multiple advantages, an acceptable method for reconstructions after resection of intraoral malignancies.

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Microsurgical free tissue transfer as avaluable reconstructive procedure in foot reconstruction

Indian Journal of Plastic Surgery ◽

10.1055/s-0039-1699192 ◽

2007 ◽

Vol 40 (02) ◽

pp. 141-146

Author(s):

mohamed el-shazly ◽

mohamed makboul

Keyword(s):

Free Flap ◽

Motor Vehicle ◽

Donor Site ◽

Free Tissue Transfer ◽

Free Flaps ◽

Vehicle Accidents ◽

Tissue Transfer ◽

Scapular Flap ◽

Radial Forearm ◽

Foot Reconstruction

ABSTRACT Background: owing to the limited soft tissue donor sites in the foot area, the use of microsurgical tissue transfer is frequently becoming mandatory in this area, especially in cases of massive defects due to the common motor vehicle accidents in the territory of upper egypt. free flaps offer a great variety of available tissues to cover larger, multifocal or multistructural defects. they also improve the perfusion of the infected poorly perfused areas.Objectives: in this study, we tried to evaluate foot defects according to their size, shape and site and to determine the general and specific parameters of free tissue transfer to the foot area in concomitance with the patients needs.Materials and methods: eleven patients were included in this study. for each patient, complete history was taken, general and local examination, photographic documentation, laboratory investigations, imaging and other investigations were performed. free flap transfers were applied in all cases as follows: latissimus dorsi flap in five cases, rectus abdominis flap in three cases, scapular flap in one case, gracilis flap in one case and radial forearm flap in one case.Results: nine flaps survived. no infection or donor site complications were recorded. every patient had the optimum free flap as regards the defect size, site, depth, condition, shape, donor site availability and the recipient vessels′ condition.Conclusion: the study of the optimum free flap for foot reconstruction in relation to the defect present and patient conditions is crucial to have significant results.

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Short-term donor site morbidity: A comparison of the anterolateral thigh and radial forearm fasciocutaneous free flaps

Head & Neck ◽

10.1002/hed.24131 ◽

2015 ◽

Vol 38 (S1) ◽

pp. E945-E948 ◽

Cited By ~ 20

Author(s):

P. Daniel Knott ◽

Rahul Seth ◽

Heather H. Waters ◽

Peter C. Revenaugh ◽

Daniel Alam ◽

...

Keyword(s):

Donor Site ◽

Free Flaps ◽

Donor Site Morbidity ◽

Short Term ◽

Anterolateral Thigh ◽

Radial Forearm

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Free Flap Reconstruction for Complex Scalp and Forehead Defects with Associated Full-Thickness Calvarial Bone Resections

Craniomaxillofacial Trauma & Reconstruction ◽

10.1055/s-0032-1322534 ◽

2012 ◽

Vol 5 (4) ◽

pp. 205-211 ◽

Cited By ~ 11

Author(s):

Juan Larrañaga ◽

Alfredo Rios ◽

Edgardo Franciosi ◽

Eduardo Mazzaro ◽

Marcelo Figari

Keyword(s):

Latissimus Dorsi ◽

Vastus Lateralis ◽

Donor Site ◽

Free Flaps ◽

Latissimus Dorsi Flap ◽

Calvarial Bone ◽

No Donor ◽

Anterolateral Thigh ◽

Radial Forearm ◽

Anterolateral Thigh Flaps

Extensive defects of the scalp and forehead associated with calvarial bone resections demand complex reconstructions. Free flaps offer vascularized tissue of excellent quality and quantity. We report six patients with extensive scalp and forehead defects associated with calvarial bone resections reconstructed with free flaps. Five patients also required a cranioplasty. The flaps used were two anterolateral thigh flaps, one vastus lateralis flap, one myocutaneous latissimus dorsi flap, one latissimus dorsi flap, and one radial forearm flap. All flaps survived with no partial necrosis. There were no donor site complications. One patient presented an exposure of the alloplastic material used for cranioplasty. We strongly recommend the use of free flaps for this kind of reconstruction.

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Novel STSG Donor Site for Forearm Flaps: Radial Skin Paddle

Otolaryngology ◽

10.1016/j.otohns.2008.05.103 ◽

2008 ◽

Vol 139 (2_suppl) ◽

pp. P31-P31

Author(s):

Tamer Abdel-Halim Ghanem ◽

Mark K Wax

Keyword(s):

Free Flap ◽

Medical Center ◽

Donor Site ◽

Free Tissue Transfer ◽

Free Flaps ◽

Patch Repair ◽

Skin Grafts ◽

Skin Paddle ◽

Forearm Skin ◽

Radial Forearm

Objective Split thickness skin grafts (STSG) harvested from the thigh are often utilized to provide coverage for radial forearm donor sites. To eliminate the morbidity of the thigh STSG donor site, we assessed the feasibility of harvesting the STSG from the radial. Methods Prospective data was collected from patients undergoing forearm free flap reconstruction at a tertiary medical center in a 6-month period. The radial forearm free flap (RFFF) harvesting procedure was modified to incorporate STSG harvest from the paddle site as the first step after arm tourniquet activation. Results There were 27 patients in this cohort, with mean age of 68.2. There were 24 fasciocutaneous RFFF, 2 osteocutaneous RFFF, and 1 ulnar flap. The indications for free tissue transfer were as follows: intraoral defects (n=13), pharyngeal patch repair (n=8), total laryngopharyngectomy (n=1), external skin coverage (n=5). The mean forearm defect was 41.2 cm2 (24–77 cm2). 22 out of 27 skin grafts were non-meshed. Harvesting from the forearm skin paddle was successful in 25 patients (93%). Two patients required a thigh STSG; both patients were octagenerians with frail skin. All the forearm donor sites healed well, except one patient required a later revision procedure for exposed tendon. Conclusions Based on this study, the thigh STSG donor site can be eliminated in 9 out of 10 patients undergoing radial forearm free flaps. This translates to decreased risk of pain, infection, and wound oozing. Older patients with frail skin and atrophied forearm muscles were likely to require a thigh donor site.

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Creating Two Independent Fasciocutaneous Free Flaps From a Single Radial Forearm Donor Site

Annals of Plastic Surgery ◽

10.1097/00000637-200109000-00005 ◽

2001 ◽

Vol 47 (3) ◽

pp. 247-251 ◽

Cited By ~ 4

Author(s):

Tun?? ??afak ◽

Mustafa Aky??rek

Keyword(s):

Donor Site ◽

Free Flaps ◽

Radial Forearm

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Anterolateral thigh free flaps and radial forearm free flaps in head and neck reconstruction: A 20-year analysis from a single institution

Archives of Plastic Surgery ◽

10.5999/aps.2020.01529 ◽

2021 ◽

Vol 48 (1) ◽

pp. 49-54

Author(s):

Simon Yang ◽

Jong Won Hong ◽

In Sik Yoon ◽

Dae Hyun Lew ◽

Tai Suk Roh ◽

...

Keyword(s):

Head And Neck ◽

Donor Site ◽

Free Flaps ◽

Cancer Site ◽

Head And Neck Reconstruction ◽

Single Institution ◽

Reconstruction Surgery ◽

Neck Reconstruction ◽

Anterolateral Thigh ◽

Radial Forearm

Background Reconstruction after removal of a malignant tumor in the head and neck region is crucial for restoring tissue integrity, function, and aesthetics. We retrospectively analyzed patients who underwent intraoral reconstruction surgery using radial forearm free flaps (RFFF) and anterolateral thigh free flaps (ALT) at a single institution to provide more information supporting the choice of a reconstruction method after removal of head and neck cancer.Methods The charts of 708 patients who underwent head and neck reconstruction between 1998 and 2018 at the Department of Plastic and Reconstructive Surgery at our institution were retrospectively reviewed. Patients’ age, sex, and history of radiation therapy, diabetes mellitus, and smoking were retrieved. The primary cancer site, types of defects, and complications were investigated.Results Overall, 473 and 95 patients underwent reconstruction surgery with RFFF and ALT, respectively. RFFF was more often used in patients with cancers of the pharynx, larynx, esophagus, or tonsil, while ALT was more frequently used in patients with cancers of the mouth floor with tonsil or tongue involvement. The proportion of patients undergoing ALT increased gradually. Flap failure and donor site morbidities did not show significant differences between the two groups.Conclusions RFFF and ALT flaps resulted in similar outcomes in terms of flap survival and donor site morbidity. ALT can be an option for head and neck reconstruction surgery in patients with large and complex defects or for young patients who want to hide their donor site scars.

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Use of Autologous Skin Equivalents With Artificial Dermal Matrix (Integra) in Donor Site Coverage in Radial Forearm Free Flaps: Preliminary Cases

Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.joms.2011.10.028 ◽

2012 ◽

Vol 70 (10) ◽

pp. 2453-2458 ◽

Cited By ~ 10

Author(s):

Ignacio Peña ◽

Lucas de Villalaín ◽

Eva García ◽

Luis Manuel Junquera ◽

Juan Carlos de Vicente

Keyword(s):

Donor Site ◽

Free Flaps ◽

Dermal Matrix ◽

Skin Equivalents ◽

Radial Forearm

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Minimising the donor area morbidity of radial forearm phalloplasty using prefabricated thigh flap: A new technique

Indian Journal of Plastic Surgery ◽

10.4103/ijps.ijps_158_16 ◽

2017 ◽

Vol 50 (01) ◽

pp. 091-095 ◽

Cited By ~ 4

Author(s):

Aditya Aggarwal ◽

Hardeep Singh ◽

Sanjay Mahendru ◽

Vimalendu Brajesh ◽

Sukhdeep Singh ◽

...

Keyword(s):

Donor Site ◽

Tissue Expander ◽

Tissue Expansion ◽

Skin Grafting ◽

Free Flaps ◽

Standing Position ◽

Donor Site Morbidity ◽

New Technique ◽

Donor Area ◽

Radial Forearm

ABSTRACTPhalloplasty is indicated in various conditions of penile loss or absence. There are numerous techniques for phalloplasty including the pedicle and free flaps with the ultimate goal of micturition in standing position, attaining adequate size, aesthesis and sensations for sexual intercourse. Radial forearm phalloplasty is the gold standard flap to achieve above results but gives a very bad scar on the forearm. We present a technique of using prefabricated thigh flap to reduce the morbidity of donor area. The descending branch of lateral circumflex femoral pedicle was placed in a subcutaneous plane over tissue expander. After attaining an adequate size of flap with tissue expansion, it was delayed 3 weeks before phalloplasty. Prefabricated flap was thin and of large size replicating the radial forearm flap used for phalloplasty. Whole forearm defect was covered with the thigh flap, and the thigh could be closed primarily. This new technique of using prefabricated thigh flap has significantly reduced the donor site morbidity both aesthetically and functionally without the use of skin grafting in the whole procedure.

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