ABSTRACT
Microsurgical techniques have developed numerous territories suitable for free tissue
transfer. However, the demand for thin cutaneous resurfacing limits the choice of
flaps available to the reconstructive microsurgeon. The radial forearm flap is a thin,
axial, fasciocutaneous flap, offering pliable cutaneous resurfacing, with or without
sensation.
We have used 15 flaps to reconstruct defects in the head and neck and lower extremity
resulting from burns, blunt and avulsive trauma, radiation necrosis, and tumor ablation.
Two flaps (15 percent) developed venous congestion and were salvaged by reoperation.
One retrograde flap (7.5 percent) developed partial necrosis from arterial insufficiency.
Neural re-innervation was successful in two out of three patients in whom it was attempted.
Two patients (15 percent) sustained minor donor site skin graft loss that healed secondarily.
In our series of predominantly older patients the donor sites have been relatively
inconspicuous at one year follow-up. A functional restoration was achieved in all
patients.
