eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Reconstructive Surgery

Tissue Transfer, Radial Forearm: Follow-up

Author: Mark K Wax, MD, Professor and Program Director, Department of Otolaryngology-Head and Neck Surgery, Oregon Health Sciences University; Service Chief, Department of Surgery, Section of Otolaryngology, Veterans Affairs Medical Center
Coauthor(s): Catherine P Winslow, MD, Consulting Surgeon, Winslow Facial Plastic Surgery, LLC
Contributor Information and Disclosures

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.

 


More on Tissue Transfer, Radial Forearm

Overview: Tissue Transfer, Radial Forearm
Workup: Tissue Transfer, Radial Forearm
Treatment: Tissue Transfer, Radial Forearm
Follow-up: Tissue Transfer, Radial Forearm
Multimedia: Tissue Transfer, Radial Forearm
References

References

  1. 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].

  2. 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].

  3. 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].

  4. 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].

  5. 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].

  6. 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].

  7. 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].

  8. 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].

  9. 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.

  10. 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].

  11. 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

Contributor Information and Disclosures

Author

Mark K Wax, MD, Professor and Program Director, Department of Otolaryngology-Head and Neck Surgery, Oregon Health Sciences University; Service Chief, Department of Surgery, Section of Otolaryngology, Veterans Affairs Medical Center
Mark K Wax, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Bronchoesophagological Association, American College of Surgeons, American Rhinologic Society, American Society for Head and Neck Surgery, American Society for Laser Medicine and Surgery, Canadian Academy of Facial Plastic and Reconstructive Surgery, North American Skull Base Society, and Royal College of Physicians and Surgeons of Canada
Disclosure: Nothing to disclose.

Coauthor(s)

Catherine P Winslow, MD, Consulting Surgeon, Winslow Facial Plastic Surgery, LLC
Catherine P Winslow, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, and American Academy of Otolaryngology-Head and Neck Surgery
Disclosure: Nothing to disclose.

Medical Editor

Terance (Terry) Ted Tsue, MD, Vice-Chairman for Administrative Affairs, Professor, Residency Program Director, Department of Otolaryngology-Head and Neck Surgery, University of Kansas School of Medicine
Terance (Terry) Ted Tsue, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Society for Head and Neck Surgery, Association for Research in Otolaryngology, Johns Hopkins Medical and Surgical Association, Missouri State Medical Association, Phi Beta Kappa, and Society of University Otolaryngologists-Head and Neck Surgeons
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

David W Stepnick, MD, Associate Professor, Departments of Plastic Surgery and Otolaryngology-Head and Neck Surgery, Case Western Reserve University School of Medicine, University Hospitals of Cleveland Case Medical Center
David W Stepnick, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Society for Head and Neck Surgery, and Society of University Otolaryngologists-Head and Neck Surgeons
Disclosure: Nothing to disclose.

CME Editor

Christopher L Slack, MD, Otolaryngology-Facial Plastic Surgery, Private Practice, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders
Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA, Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine
Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society
Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation unstricted gift unknown

 
 
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