Decision Making in Skin Paddle Design of Pedicled Radial Forearm Flap
Abstract
The Elbow is one of the functional big joints that is at risk of trauma, especially during traffic accidents. Although the reconstruction ladder is the priority, regional flaps have some advantages, including pliable tissues, being far from the danger zone of trauma, and having sufficient tissue. A 32-year-old man who suffered severe injury to the upper limb was referred for reconstruction. The fractured elbow had a plate that should be covered with sufficient soft tissue and skin. Proximally based fascio-cutaneous forearm flap, designed and harvested preserving perforators, and transferred safely. There are small septocutaneous perforators from the radial artery to the wrist skin. Fine microscopic dissection should be done to preserve this perforator to achieve a small skin paddle for harvest on the distal part of the wrist. The radial forearm flap should be considered in elbow skin defects. This proximally based flap has robust nourishment and can be harvested safely.
2. Zeng Q, Cai G, Liu D, Wang K, Zhang X. Successful salvage of the upper limb after crush injury requiring nine operations: a case report. Int Surg 2015;100:540-6.
3. Wu G, Zhang Z, Zhang F, Zhang Y, Wang Q, Yu W. The free flap based on a single proximal perforator of the radial artery: ultrasonography study and clinical applications in reconstruction of soft tissue defects in finger. Eur J Med Res 2022;27:85.
4. Adkinson JM, Chung KC. Flap reconstruction of the elbow and forearm: a case-based approach. Hand Clin 2014;30:153-63.
5. Sohrabi C, Mathew G, Maria N, Kerwan A, Franchi T, Agha RA. The SCARE 2023 guideline:updating consensus Suegical CAse RE port (SCARE)guidelines.Int J Surg Lond Engl 2023:109:1136
6. Georgescu AV, Matei I, Ardelean F, Capota I. Microsurgical Non-microvascular flaps in forearm and hand reconstruction. Microsurgery 2007;27:384-94.
7. Hansen AJ, Duncan SF, Smith AA, Shin AY, Moran SL, Bishop AT. Reverse radial forearm fascial flap with radial artery preservation. Hand (N Y) 2007;2:159-63.
8. Breik O, Selbong U, Laugharne D, Jones K. Dealing with vascular anomalies during radial forearm free flap harvest: report of two cases and review of the literature. Int J Oral Maxillofac Surg 2019;48:1509-15.
9. Hekner DD, Roeling TAP, Van Cann EM. Perforator anatomy of the radial forearm free flap versus the ulnar forearm free flapfor head and neck reconstruction, Int J Oral Maxillofac Surg 2016;45:955-9.
10. McCrary HC, Farlow JL, Alexander J, Haring CT, Kang SY, Old MO, et al. The osteocutaneous radial forearm free flap: A pictorial essay. Head Neck 2024;46:1533-41.
Files | ||
Issue | Vol 63 No 3 (2025) | |
Section | Case Report(s) | |
DOI | https://doi.org/10.18502/acta.v63i3.19720 | |
Keywords | ||
Elbow skin defect Radial forearm flap Perforator flap |
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