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J Reconstr Microsurg 2012; 28(02): 133-138
DOI: 10.1055/s-0031-1289165
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Donor-Site Morbidity of the Sensate Extended Lateral Arm Flap

Christian Depner
1   Department of Plastic, Reconstructive, and Aesthetic Surgery, University Hospital of Basel, Basel, Switzerland
,
Paolo Erba
2   Department of Plastic, Reconstructive, and Aesthetic Surgery, University Hospital of Lausanne, Lausanne, Switzerland
,
Ulrich M. Rieger
1   Department of Plastic, Reconstructive, and Aesthetic Surgery, University Hospital of Basel, Basel, Switzerland
3   Department of Plastic and Reconstructive Surgery, Medical University Innsbruck, Innsbruck, Austria
,
Fabienne Iten
1   Department of Plastic, Reconstructive, and Aesthetic Surgery, University Hospital of Basel, Basel, Switzerland
,
Dirk J. Schaefer
1   Department of Plastic, Reconstructive, and Aesthetic Surgery, University Hospital of Basel, Basel, Switzerland
,
Martin Haug
1   Department of Plastic, Reconstructive, and Aesthetic Surgery, University Hospital of Basel, Basel, Switzerland
› Author Affiliations
Further Information

Publication History

18 June 2011

17 July 2011

Publication Date:
29 September 2011 (online)

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Abstract

The free extended lateral arm flap (ELAF) has gained increasing popularity thank to its slimness and versatility, longer neurovascular pedicle, and greater flap size when compared with the original flap design. The aim of this study was to assess the donor-site morbidity associated with this extended procedure. A retrospective study of 25 consecutive patients analyzing postoperative complications using a visual analogue scale questionnaire revealed high patients satisfaction and negligible donor-site morbidity of the ELAF. Scar visibility was the commonest negative outcome. Impaired mobility of the elbow had the highest correlation with patient dissatisfaction. Sensory deficits or paresthetic disorders did not affect patient satisfaction. The extension of the lateral arm flap and positioning over the lateral humeral epicondyle is a safe and well-accepted procedure with minimal donor-site morbidity. To optimize outcomes, a maximal flap width of 6 or 7 cm and intensive postoperative mobilization therapy is advisable.

Keywords

lateral arm flap - donor site morbidity - sensate free flap
 

  • References

  • 1 Song R, Song Y, Yu Y, Song Y. The upper arm free flap. Clin Plast Surg 1982; 9 (1) 27-35
    PubMedGoogle Scholar
  • 2 Katsaros J, Schusterman M, Beppu M, Banis JC Jr, Acland RD. The lateral upper arm flap: anatomy and clinical applications. Ann Plast Surg 1984; 12 (6) 489-500
    CrossrefPubMedGoogle Scholar
  • 3 Waterhouse N, Healy C. The versatility of the lateral arm flap. Br J Plast Surg 1990; 43 (4) 398-402
    CrossrefPubMedGoogle Scholar
  • 4 Malata CM, Tehrani H, Kumiponjera D, Hardy DG, Moffat DA. Use of anterolateral thigh and lateral arm fasciocutaneous free flaps in lateral skull base reconstruction. Ann Plast Surg 2006; 57 (2) 169-175 ; discussion 176
    CrossrefPubMedGoogle Scholar
  • 5 Karamürsel S, Bağdatlý D, Markal N, Demir Z, Celebioğlu S. Versatility of the lateral arm free flap in various anatomic defect reconstructions. J Reconstr Microsurg 2005; 21 (2) 107-112
    Article in Thieme ConnectPubMedGoogle Scholar
  • 6 Culbertson JH, Mutimer K. The reverse lateral upper arm flap for elbow coverage. Ann Plast Surg 1987; 18 (1) 62-68
    CrossrefPubMedGoogle Scholar
  • 7 Kalbermatten DF, Wettstein R, vonKanel O , et al. Sensate lateral arm flap for defects of the lower leg. Ann Plast Surg 2008; 61 (1) 40-46
    CrossrefPubMedGoogle Scholar
  • 8 Haas F, Ensat F, Windhager R, Stammberger H, Koch H, Scharnagl E. Reconstructive potential of the lateral arm flap after tumor resection. Microsurgery 2007; 27 (3) 166-173
    CrossrefPubMedGoogle Scholar
  • 9 Scheker LR, Kleinert HE, Hanel DP. Lateral arm composite tissue transfer to ipsilateral hand defects. J Hand Surg Am 1987; 12 (5 Pt 1) 665-672 [Am]
    PubMedGoogle Scholar
  • 10 Clymer MA, Burkey BB. Other flaps for head and neck use: temporoparietal fascial free flap, lateral arm free flap, omental free flap. Facial Plast Surg 1996; 12 (1) 81-89
    Article in Thieme ConnectPubMedGoogle Scholar
  • 11 Gordon DJ, Small JO. The addition of muscle to the lateral arm and radial forearm flaps for wound coverage. Plast Reconstr Surg 1992; 89 (3) 563-566
    CrossrefPubMedGoogle Scholar
  • 12 Matloub HS, Larson DL, Kuhn JC, Yousif NJ, Sanger JR. Lateral arm free flap in oral cavity reconstruction: a functional evaluation. Head Neck 1989; 11 (3) 205-211
    CrossrefPubMedGoogle Scholar
  • 13 O'Brien BM. Reconstructive microsurgery of the upper extremity. J Hand Surg Am 1990; 15 (2) 316-321 [Am]
    CrossrefPubMedGoogle Scholar
  • 14 Civantos FJ Jr, Burkey B, Lu FL, Armstrong W. Lateral arm microvascular flap in head and neck reconstruction. Arch Otolaryngol Head Neck Surg 1997; 123 (8) 830-836
    CrossrefPubMedGoogle Scholar
  • 15 Katsaros J, Tan E, Zoltie N, Barton M, Venugopalsrinivasan Venkataramakrishnan. Further experience with the lateral arm free flap. Plast Reconstr Surg 1991; 87 (5) 902-910
    CrossrefPubMedGoogle Scholar
  • 16 Kuek LB, Chuan TL. The extended lateral arm flap: a new modification. J Reconstr Microsurg 1991; 7 (3) 167-173
    Article in Thieme ConnectPubMedGoogle Scholar
  • 17 Hamdi M, Coessens BC. Evaluation of the donor site morbidity after lateral arm flap with skin paddle extending over the elbow joint. Br J Plast Surg 2000; 53 (3) 215-219
    CrossrefPubMedGoogle Scholar
  • 18 Hamdi M, Coessens BC. Distally planned lateral arm flap. Microsurgery 1996; 17 (7) 375-379
    CrossrefPubMedGoogle Scholar
  • 19 Graham B, Adkins P, Scheker LR. Complications and morbidity of the donor and recipient sites in 123 lateral arm flaps. J Hand Surg [Br] 1992; 17 (2) 189-192 [Br]
    PubMedGoogle Scholar
  • 20 Gellrich NC, Schramm A, Hara I, Gutwald R, Düker J, Schmelzeisen R. Versatility and donor site morbidity of the lateral upper arm flap in intraoral reconstruction. Otolaryngol Head Neck Surg 2001; 124 (5) 549-555
    CrossrefPubMedGoogle Scholar
  • 21 Marques Faria JC, Rodrigues ML, Scopel GP, Kowalski LP, Ferreira MC. The versatility of the free lateral arm flap in head and neck soft tissue reconstruction: clinical experience of 210 cases. J Plast Reconstr Aesthet Surg 2008; 61 (2) 172-179
    CrossrefPubMedGoogle Scholar
  • 22 Atzei A, Pignatti M, Udali G, Cugola L, Maranzano M. The distal lateral arm flap for resurfacing of extensive defects of the digits. Microsurgery 2007; 27 (1) 8-16
    CrossrefPubMedGoogle Scholar
  • 23 Hage JJ, Woerdeman LA, Smeulders MJ. The truly distal lateral arm flap: rationale and risk factors of a microsurgical workhorse in 30 patients. Ann Plast Surg 2005; 54 (2) 153-159
    CrossrefPubMedGoogle Scholar