gms | German Medical Science

Objectives/Interrogation: The radial forearm flap is one of the most reliable conventional type of flaps. This is due to its thinness, pliability, good vascularization, relative hairlessness and good sensation. The disadvantages lies in radial artery sacrifice and donor-site morbidity. The increasing understanding of the local anatomy has allowed for the identification of perforating branches of the radial artery that allow for the subdivision of the radial flap into two or three components (Figure 1 [Fig. 1]). Rotation of each small component can reach up 180 degree. This modification allows contouring of the flap to a wide range of recipient sites, while permitting the primary donor side closure [1].

Methods: From 2014 to 2016, 5 patients (4 males and 1 female) were treated by "a modified radial artery perforator flap". Free flaps from the contralateral limb were used in 2 cases and pedicled flaps were used in 3 cases. The age of the patients ranged from 7 to 52 years. The reconstructed areas involved the hand in 4 cases and the elbow in one case, all of which were traumatic in nature. Outcomes included flap survival, complications and donor site morbidity (Table 1 [Tab. 1]).

Results and Conclusions: All flaps survived without signs of necrosis. The donor site was closed primarily in three cases. In the remaining cases, the donor site was initially covered with a dermal regeneration template followed by skin grafting three weeks later. There were no cases of impaired blood circulation of the hand or cold intolerance after sacrifice of the radial artery. The flap may be considered an alternative method to other reconstructive techniques especially when reconstruction has to match the concept of "like to like".