Arch Plast Surg.  2018 Jul;45(4):345-350. 10.5999/aps.2018.00115.

Reducing the donor site morbidity in radial forearm free flaps by utilizing a narrow radial forearm free flap

Affiliations
  • 1Department of Plastic Surgery, Liaquat National Hospital, Karachi, Pakistan.
  • 2Department of General Surgery, Aga Khan University Hospital, Karachi, Pakistan. drns01@hotmail.com

Abstract

BACKGROUND
The radial forearm free flap (RFFF) has remained a leading choice of many plastic surgeons as a fasciocutaneous flap due to its versatility, pedicle length, and simple elevation technique. However, donor site morbidity has led many reconstructive surgeons to limit their use of the RFFF and to use other flaps instead. We propose that using a narrow RFFF (nRFFF) decreases the aesthetic and functional morbidity of the donor site.
METHODS
We report our experiences with the nRFFF from April 2012 through May 2015 at the Department of Plastic, Reconstructive, and Hand Surgery at Liaquat National Hospital, Karachi. The donor defects were closed primarily. The Stony Brook Scar Evaluation Scale and comparison with the contralateral hand were used to assess aesthetic and functional outcomes, respectively.
RESULTS
A total of 24 patients underwent nRFFF procedures during the study period. The donor arm showed excellent motor function in 22 cases (91.7%), and very good function in the remaining two cases (8.3%). The aesthetic outcomes were excellent in four patients (16.6%), very good in eight patients (33.3%), good in 10 patients (41.6%), and fair in two patients (8.3%) who developed a hypertrophic scar. All flaps were successful and there were no cases of partial or complete loss.
CONCLUSIONS
For small to medium-sized soft tissue defects, the nRFFF had acceptable outcomes due to its thinness, pliability, and major reduction in donor site aesthetic and functional morbidity.

Keyword

Free tissue flaps; Reconstructive surgery; Cicatrix, hypertrophic

MeSH Terms

Arm
Cicatrix
Cicatrix, Hypertrophic
Forearm*
Free Tissue Flaps*
Hand
Humans
Plastics
Pliability
Surgeons
Thinness
Tissue Donors*
Plastics
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