The Radial Forearm Flap

2019 ◽  
pp. 375-382
Author(s):  
Brogan G. A. Evans ◽  
Gregory R. D. Evans
Keyword(s):  
Patient Management ◽  
Free Tissue Transfer ◽  
Free Flaps ◽  
Radial Forearm Flap ◽  
Forearm Flap ◽  
Preoperative Marking ◽  
Great Utility ◽  
Radial Forearm ◽  
Good Cosmesis ◽  
Tissue Defects

Radial forearm free-flaps (RFFF) offer great utility in the reconstruction of intraoral soft tissue defects. The use of a free tissue transfer with the radial forearm flap can obviate poor wound healing and replace previously irradiated tissue with well-perfused normal fascia and skin. Considerable care must be taken by the surgeon to preserve adequate function of speech and swallow, as well as to obtain good cosmesis. Knowledge of proper anatomical orientation and preoperative marking provide keys to a successful flap dissection and intraoral reconstruction. After reading this chapter, the reader should have an understanding of the assessment of intraoral defects, indications for RFFF, intraoperative techniques, and marking, as well as postoperative patient management.

scholarly journals Microvascular skin coverage in wounds that expose the Achilles tendon

2021 ◽  
Vol 9 (12) ◽  
pp. 3733
Author(s):  
Baltazar Barrera-Mera ◽  
Israel Salgado-Adame ◽  
Obed Horacio Grajeda-Chávez ◽  
Jazmín Danaé Chávez-Hernández ◽  
Cuauhtémoc Aguilar-Barragán ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Achilles Tendon Rupture ◽  
Free Flaps ◽  
The Body ◽  
Radial Forearm Flap ◽  
Forearm Flap ◽  
Skin Defects ◽  
Free Radial Forearm Flap ◽  
Radial Forearm ◽  
Skin Coverage

Achilles tendon rupture is one of the most frequent tendon ruptures. Surgical intervention is the best option, but it has a high rate of complications leading to skin infections and necrosis. Extensive and aggressive debridement is necessary, producing tendon exposure and large skin defects. There are many alternatives for the skin coverage of the Achilles tendon, like sequential closures, vacuum assisted closure, local flaps, regional flaps, and more recently and efficiently microsurgery flaps. Skin defects in the Achilles tendon region have many peculiarities in comparison with other parts of the body: it is a zone that is always under mechanical stress due to footwear, this is why it must be highly resistant but thin. Its coverage must have sensitive properties, endure tendon gliding and allow early rehabilitation. Sometimes tendon reinforcement or creation or a neo tendon will be needed. For fulfilling these requirements free flaps by microsurgery are the only option in 90% of the cases. In this review article, we analyze three of the most frequently used free flaps in reconstructive medicine for complex Achilles tendon defects; free radial forearm flap, free radial forearm flap with vascularized flexor carpi radialis tendon and free anterolateral thigh (ALT) flap with vascularized fascia lata. This choice will be determined by the number of tissues involved, size of the defect, etiology of the defect, overall condition of the affected extremity and quality of neighboring tissues.

scholarly journals Dorsalis Pedis Free Flap: The Salvage Option following Failure of the Radial Forearm Flap in Total Lower Lip Reconstruction

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Theodoros Stathas ◽  
Georgios Tsinias ◽  
Dimitra Tsiliboti ◽  
Aris Tsiros ◽  
Nicholas Mastronikolis ◽  
...  
Keyword(s):  
Free Flap ◽  
Free Flaps ◽  
Radial Forearm Flap ◽  
Lower Lip ◽  
Lip Reconstruction ◽  
Forearm Flap ◽  
Radial Forearm ◽  
Lip Carcinoma ◽  
The Aesthetic ◽  
Lip Defect

Reconstruction after resection of large tumors of the lower lip requires the use of free flaps in order to restore the shape and the function of the lip, with the free radial forearm flap being the most popular. In this study we describe our experience in using the dorsalis pedis free flap as a salvage option in reconstruction of total lower lip defect in a patient with an extended lower lip carcinoma after failure of the radial forearm free flap, that was initially used. The flap was integrated excellently and on the followup the patient was free of disease and fully satisfied with the aesthetic and functional result.

scholarly journals Objective Selection Criteria between ALT and Radial Forearm Flap in Oral Soft Tissues Reconstruction

2019 ◽  
Vol 52 (02) ◽  
pp. 166-170 ◽  
Author(s):  
Elisa Benanti ◽  
Marta Starnoni ◽  
Antonio Spaggiari ◽  
Massimo Pinelli ◽  
Giorgio De Santis
Keyword(s):  
Soft Tissues ◽  
Three Dimensional ◽  
Perforator Flap ◽  
Free Flaps ◽  
Radial Forearm Flap ◽  
Life Questionnaire ◽  
Forearm Flap ◽  
First Choice ◽  
Radial Forearm ◽  
Magnetic Resonance Imaging Mri

AbstractDifferent locoregional and free flaps were described for oral soft tissues reconstruction after oncological resections; however, free flaps remain the first choice. Among free flaps, the radial forearm flap (RFF) and the anterolateral thigh perforator flap (ALT) are preferred the most. The lack of standardization of the flap choice leaves the selection to the surgeon's experience. The purpose of our observational study is to provide an algorithm to support the flap choice for the reconstruction of oral soft tissues. Sixty patients with squamous cell carcinoma of oral soft tissues were enrolled in our study. All the patients underwent preoperative magnetic resonance imaging (MRI) to measure the three-dimensional size of the tumor. During the follow-up, the patients were evaluated by using the University of Washington-Quality of Life Questionnaire. The questionnaire score was better for small tumors and worse for large tumors in both functional and relational fields. We observed that most of the overlapping results were obtained for small defects and the choice of RFF, as well as for large defects and the use of ALT. We observed that in the preoperative time, it is possible to select which flap between radial forearm and ALT is more appropriate for oral soft tissues defects reconstruction, according to the size of the tumor evaluated by MRI. We propose a decisional algorithm that suggests the type of flap to use between ALT and RFF.

scholarly journals Iatrogenic Damage of the Pedicle of Radial Forearm Free Flap Repaired with Super-Microsurgery Techniques: A Case Report

2020 ◽  
Vol 14 (1) ◽  
pp. 31
Author(s):  
Jonathan Velazquez- Mujica ◽  
Hung Chi Chen ◽  
Juan Carlos Reyes Cerda
Keyword(s):  
Superficial Temporal Artery ◽  
Free Flaps ◽  
Temporal Artery ◽  
Radial Forearm Flap ◽  
Salvage Procedure ◽  
Large Defect ◽  
Forearm Flap ◽  
Free Radial Forearm Flap ◽  
Iatrogenic Damage ◽  
Radial Forearm

Introduction: Accidental Iatrogenic damage of the pedicle or perforators has been frequently reported as a cause of failure of free flaps. Free radial forearm flap helps to cover defects that are not possible to cover with local flaps or skin graft.Case Presentation: A 91 years old patient with Bowen Disease had multiple actinic keratosis and a history of squamous cell carcinoma over the forehead, which was removed 4 years before. The recurrent tumor was detected and wide excision of the tumor was done. It resulted in a large defect of 8 x 5.5 cm2 in diameter at the forehead with exposure of bone, therefore, a free radial forearm flap was performed for reconstruction with right superficial temporal artery and vein as recipient’s vessel. We observed leakage of blood through the radial artery near to the anastomosis due to iatrogenic damage during flap harvesting.Conclusions: Nowadays, repairing iatrogenic damage through the main pedicle or perforators of the pedicle is possible with super-microsurgery technique due to the improvement of the skills and smaller sutures avoiding the obstruction of the lumen of the pedicle or perforator. This is considered a salvage procedure instead of harvesting new free flaps and can be useful for all kinds of free flaps.

scholarly journals Reconstructive Surgery for Severe Penile Inadequacy: Phalloplasty with a Free Radial Forearm Flap or a Pedicled Anterolateral Thigh Flap

2008 ◽  
Vol 2008 ◽  
pp. 1-5 ◽  
Author(s):  
N. Lumen ◽  
S. Monstrey ◽  
P. Ceulemans ◽  
E. van Laecke ◽  
P. Hoebeke
Keyword(s):  
Free Flaps ◽  
Functional Results ◽  
Good Alternative ◽  
Radial Forearm Flap ◽  
Anterolateral Thigh Flap ◽  
Forearm Flap ◽  
Free Radial Forearm Flap ◽  
Anterolateral Thigh ◽  
Aesthetic Results ◽  
Radial Forearm

Objectives. Severe penile inadequacy in adolescents is rare. Phallic reconstruction to treat this devastating condition is a major challenge to the reconstructive surgeon. Phallic reconstruction using the free radial forearm flap (RFF) or the pedicled anterolateral thigh flap (ALTF) has been routinely used in female-to-male transsexuals. Recently we started to use these techniques in the treatment of severe penile inadequacy.Methods. Eleven males (age 15 to 42 years) were treated with a phallic reconstruction. The RFF is our method of choice; the ALTF is an alternative when a free flap is contraindicated or less desired by the patient. The RFF was used in 7 patients, the ALTF in 4 patients. Mean followup was 25 months (range: 4–49 months). Aesthetic and functional results were evaluated.Results. There were no complications related to the flap. Aesthetic results were judged as “good” in 9 patients and “moderate” in 2 patients. Sensitivity in the RFF was superior compared to the ALTF. Four patients developed urinary complications (stricture and/or fistula). Six patients underwent erectile implant surgery. In 2 patients the erectile implant had to be removed due to infection or erosion.Conclusion. In case of severe penile inadequacy due to whatever condition, a phalloplasty is the preferred treatment nowadays. The free radial forearm flap is still the method of choice. The anterolateral thigh flap can be a good alternative, especially when free flaps are contraindicated, but sensitivity is markedly inferior in these flaps.

Total Ear Reconstruction with Prelaminated Radial Forearm Flap

2006 ◽  
Vol 22 (03) ◽  
Author(s):  
Catarina Rober ◽  
Fabio Aki ◽  
Luis Ishida ◽  
Julio Morais
Keyword(s):  
Radial Forearm Flap ◽  
Ear Reconstruction ◽  
Forearm Flap ◽  
Radial Forearm
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