eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Reconstructive Surgery
Tissue Transfer, Radial Forearm: Follow-up
Updated: May 8, 2009
Outcome and Prognosis
The radial forearm flap is extremely reliable. The overall flap success rate of microvascular free tissue transfer in larger series is 90-98%. Nevertheless, all microvascular procedures are dependent on the experience of the surgeon and various patient factors. A take-back rate of 10% is expected, and about half of these flaps are successfully salvaged.
Future and Controversies
The reliability of the flap and the ability to reinnervate the flap via the lateral or medial antebrachial cutaneous nerves has been well established.3 The functional implications of such reinnervation have yet to be determined. Techniques for improving donor site morbidity are also being evaluated. Improving cosmesis through different grafting materials and suture techniques will ultimately make this flap even more appealing.
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References
Demirkan F, Wei FC, Lutz BS, Cher TS, Chen IH. Reliability of the venae comitantes in venous drainage of the free radial forearm flaps. Plast Reconstr Surg. Oct 1998;102(5):1544-8. [Medline].
Daya M, Nair V. Free radial forearm flap lip reconstruction: a clinical series and case reports of technical refinements. Ann Plast Surg. Apr 2009;62(4):361-7. [Medline].
Boyd B, Mulholland S, Gullane P, et al. Reinnervated lateral antebrachial cutaneous neurosome flaps in oral reconstruction: are we making sense?. Plast Reconstr Surg. Jun 1994;93(7):1350-9; discussion 1360-2. [Medline].
Brown MT, Couch ME, Huchton DM. Assessment of donor-site functional morbidity from radial forearm fasciocutaneous free flap harvest. Arch Otolaryngol Head Neck Surg. Dec 1999;125(12):1371-4. [Medline].
Funk GF, Valentino J, McCulloch TM, Graham SM, Hoffman HT. Anomalies of forearm vascular anatomy encountered during elevation of the radial forearm flap. Head Neck. Jul-Aug 1995;17(4):284-92. [Medline].
Ho T, Couch M, Carson K, Schimberg A, Manley K, Byrne PJ. Radial forearm free flap donor site outcomes comparison by closure methods. Otolaryngol Head Neck Surg. Feb 2006;134(2):309-15. [Medline].
Kim JH, Rosenthal EL, Ellis T, Wax MK. Radial forearm osteocutaneous free flap in maxillofacial and oromandibular reconstructions. Laryngoscope. Sep 2005;115(9):1697-701. [Medline].
Smith AA, Bowen CV, Rabczak T, Boyd JB. Donor site deficit of the osteocutaneous radial forearm flap. Ann Plast Surg. Apr 1994;32(4):372-6. [Medline].
Urken ML, Cheney ML, Sullivan MJ. Radial forearm free flaps. In: Atlas of Regional and Free Flaps for Head and Neck Reconstruction. Philadelphia, Pa: Lippincott-Raven; 1995.
Urken ML, Weinberg H, Vickery C, Biller HF. The neurofasciocutaneous radial forearm flap in head and neck reconstruction: a preliminary report. Laryngoscope. Feb 1990;100(2 Pt 1):161-73. [Medline].
Werle AH, Tsue TT, Toby EB, Girod DA. Osteocutaneous radial forearm free flap: its use without significant donor site morbidity. Otolaryngol Head Neck Surg. Dec 2000;123(6):711-7. [Medline].
Further Reading
Keywords
radial forearm tissue transfer, radial forearm, tissue transfer, radial forearm free tissue transfer, Chinese flap, fasciocutaneous flap, skin graft, split-thickness grafts, full-thickness grafts, radial forearm free flap
Follow-up: Tissue Transfer, Radial Forearm