ABSTRACT
The radial forearm free flap (RFFF) is one of the most widely used and versatile fasciocutaneous
free flaps in head and neck reconstruction because of its qualities-the consistent
vascular anatomy; the thin and pliable nature; the minimal hair presence; and the
possibility of harvesting and transferring it as a composite tissue flap, with bone,
tendon, and nerve. The RFFF provides a method of single-stage reconstruction of wide
residual defects after excision of advanced cancer (T3-T4) in the head and neck region.
We present our ten-year experience with RFFF and the good results obtained with some
refinements, which allowed us to verify the efficacy of the oral competence using
the palmaris gracilis tendon as a sling. We also present the possibility of harvesting
long segments of radius (up to 18 cm), and the discovery that use of antithrombotic
or anticoagulant therapy is not necessary for the flap survival.
This treatment does not guarantee a complete recovery, but it can improve the quality
of the patient's life.
KEY WORDS
free flaps - head and neck - advanced cancer
