Background to compare free thin anterolateral thigh alt flap with free radial forearm frf flap in the reconstruction of hemiglossectomy defects, and to introduce our methods and experience in the tongue reconstruction with free thin alt flap. Free radial forearm flap after partial glossectomy for squamous cell carcinoma of the tongue chuah uc,kamarul t,sara t department of orthopaedic surgery,university of malaya medical centre,50603 kuala lumpur,malaysia abstract. Folded free radial forearm flap for reconstruction of fullathickness. However, many donor site complications have been described, such as partial loss of the skin graft, sensory disturbance, tendon exposure, and esthetic. Cpt 20969 radial forearm free flap medical billing and. Download as an information leaflet pdf radial forearm flap. The extreme reliability of the radial forearm flap should be considered as one of its primary advantages. Radial forearm flap british association of oral and. Flap raising is possible simultaneous to tumor resection in the head and neck area and can be carried out quickly. The radial forearm flap is supplied by the radial artery and perforators from the radial artery to the overlying skin. Although forearm free flaps are frequently performed, there is insufficient prospective data looking at the morbidity of the radial compared to ulnar forearm free flaps.
Radial forearm free flap iowa head and neck protocols. A radial forearm free flap is one way of filling a hole which is left when a cancer has been removed. The radial forearm free flap and the ulnar forearm free flap are both welldescribed procedures used for free tissue transfer in reconstructive surgery. Total avulsed ear management with radial forearm free flap. He then does a skin graft on the donor site for closure. It presents a list of the radial forearm flap layers, and explains the radial forearm flap technique. The chinese forearm flap is vascularized by the radial artery and may be used as an island or a free flap. In 1978, a fasciocutaneous free flap from the volar aspect of the forearm and pedicled on the radial artery was first used in china. Free radial artery forearm flap in reconstruction of oral cavity cancers our experience 88 int j res med. Radial forearm free flap is regularly used in reconstruction of oral and maxillofacial region after ablative cancer surgeries. Tissue expansion of radial forearm free flap donor sites. Defects of the soft palate resulting from head and neck oncologic surgery traditionally have been rehabilitated using a prosthetic obturator.
Radial forearm versus the ulnar forearm free flap full text. Fiftyseven pedicled 43 reverse and 14 antegrade flow and 10 free radial forearm flaps were performed in 66 patients, including seven fascial flaps and one. This is surgery that removes a piece of skin from your inner forearm and uses it to replace tissue that was removed due to cancer. Used as an island flap, the pitfalls of the microsurgical procedures required for a free. Radial forearm free flap what is a radial forearm free flap. Radial forearm free flap for soft palate reconstruction. Jan 22, 2016 the fasciocutaneous radial forearm free flap fcrfff is the most common free flap used in head and neck reconstruction.
We report the first use in the uk of an osteocutaneous radial forearm free flap in the reconstruction of a subtotal nasal deficit. Rfff abbreviation stands for radial forearm free flap. The reliability of the iberic graft for covering of the. Surgical technique ottie van zyl the radial free forearm flap rfff was one of the first free tissue transfer flaps to be described. Radial forearm flap microsurgery made easy loading. The skin of the radial forearm free flap was tubed to recreate the nasal lining and the radial bone reconstructed the dorsal contour of the nose. Free radial forearm bunting flap for reconstructing softt. After a healing period of 6 months, a radial forearm free flap was harvested and the ear was reconstructed. The radial forearm free flap rfff has been widely used as a reliable reconstructive solution as it provides thin soft tissues, particularly useful to reconstruct the oral cavity and other head. Mandibular reconstruction using osteocutaneous radial forearm. Radial forearm free flap postoperative instructions. With the introduction of the radial forearm flap by song, plastic surgeons were quick to realize its potential in head and neck reconstruction. The list of acronyms and abbreviations related to rfff radial forearm free flap.
It has since become a workhorse for soft tissue replacement in head. Radial forearm free flap atlas of operative oral and. Radial forearm free flap rfff is a versatile reconstructive method, first described by yang et al. Osseocutaneous radial forearm free tissue transfer for repair. The radial forearm free flap for scalp and forehead.
Health, general oral surgery methods patient outcomes palate physiological aspects soft palate. The flap was transferred, like bunting, to the injured hand with an exteriorized pedicle. The radial forearm flap journal of plastic, reconstructive. Radial free forearm flap rfff surgical technique vula. Radial forearm free flap surgery is a versatile technique that is widely adopted for microvascular reconstruction of the oral, oropharyngeal and hypopharyngeal. Learn about the free radial forearm flap, an online 3dvideobased course, accredited by the royal college of surgeons of england. Functional outcomes following palatal reconstruction with a folded radial forearm free flap. In the cpt for skindeep tissue flaps 15xxx, it states a repair of a donor site required a skin graft or local flaps is considered an. What is the abbreviation for radial forearm free flap. The radial forearm flap is usually used in reconstruction of the mutilated hand as a reverse pedicled flap, but occasionally, a free radial forearm flap can be harvested from the contralateral forearm. Nowadays, the technique for harvesting is standardized, while reconstruction of the forearm donor site defect is somewhat controversial. Pedicled and free radial forearm flaps for reconstruction of. Radial forearm free flap free download as powerpoint presentation.
Department of plastic, reconstructive, aesthetic and hand surgery, university hospital of basel, basel, switzerland. It has since become a work horse for soft tissue replacement in. Free flaps did not, however, become widely used for hypopharyngeal reconstruction until after the refinement of microvascular techniques during the 1970s. Pdf described in 1981 by the chinese authors yang kuofan et al. The avulsed segment was deepithelialized and embedded into the volar forearm. This elearning course provides a step by step approach, lessons on objectives, preoperative information and postoperative complications, procedural anatomy and a test. Chinese flap, is a free flap technique that was developed by dr yang goufan, dr chen baoqui and dr gao yuzhi of. It must be a unicortical block of volar radius, and no wider than 1.
In the senior authors experience with 576 cases, there was a 0% incidence of free flap failure and a 0. Full thickness defects of the cheek have been conventionally reconstructed using the folded forehead flap, cervical flap, pectoralis major myocutaneous flap, or deltopectoral flap in various combinations. Although associated complications are inevitable in a percentage of patients, it is good. Doctors often use this surgery to reconstruct an area in the head and neck. Radial forearm free flap musculoskeletal system medicine. Nov 22, 2011 radial forearm free flap surgery is a versatile technique that is widely adopted for microvascular reconstruction of the oral, oropharyngeal and hypopharyngeal lining. It is one of the most common ways of replacing tissue in the head and neck, particularly after mouth cancers have been removed. When this socalled chinese flap was originally described by yang et al. Pdf folded free radial forearm flap for reconstruction of. Pdf salvage of free radial artery forearm flap following. Because of the ease of flap elevation, the radial forearm flap.
Revisiting radial forearm free flap for successful venous drainage. Tissue defect reconstruction using radial forearm free flap rfff is a common surgical technique whose success or failure is mainly. The increasing success rate of free flaps along with their reconstructive advantages have got them into regular practice options in maxillofacial reconstruction. Several types of free flaps can be used to restore defects within the oral cavity and orohypopharynx anterolateral thigh flap, rectus abdominis musculocutaneous flap, free deltoid flap, etc. Objective to evaluate the resulting aesthetics, function, and donor site morbidity of the osseocutaneous radial forearm free flap ocrfff used for midface reconstruction. Previous attempts to use an osteocutaneous radial forearm free flap ocrfff for head and neck reconstruction have been associated with unacceptable donor site morbidity, most commonly fracture of the radius. The radial forearm free flap is a viable reconstructive option for tongue defects. Microvascular surgery protocols general considerations.
Material and methods the clinicopathologic data of 46 tongue carcinoma cases hospitalized from december 2009 to april 2014 were obtained from. Your hospital stay after radial forearm free flap surgery. When your condition is stable and there is a room available, you will move to. The dominant pedicle is the radial artery, with venous outflow through the dual system of the venae comitantes and cephalic vein. Functional outcomes following palatal reconstruction with a. Osteocutaneous radial forearm free flap in subtotal nasal.
The bottomup approach to the suprafascial harvest of the radial. Second free radial forearm flap for urethral reconstruction. A, postoperative appearance 5 years after a radial forearm free flap donor site. The flap can be made sensate by inclusion of either the medial or lateral cutaneous nerves of the forearm. Radial forearm free flap pharyngoesophageal reconstruction. It is as hardy as the latissimus dorsi flap in withstanding postoperative adjuvant radiation, and confers multiple advantages over the latissimus dorsi free flap including faster healing times and shorter hospital stays. Indications the forearm flap has been used for just about everything imaginable in the area of head and neck reconstruction.
We report the use of a free radial forearm flap with multiple perforatorbased skin islands for the reconstruction of complex softtissue defects involving multiple fingers. This chapter talks about free tissue transfer indicated for the replacement of moderate to large soft tissue defects associated with ablative wounds. The radial free forearm flap rfff was one of the first free tissue transfer flaps to be described. A single surgeons experience with 67 pedicled and free radial forearm flaps for reconstruction of the elbow, wrist, and hand was analyzed retrospectively. In general, the results of soft palate obturation have been satisfactory, with most patients achieving velopharyngeal competence during speech and swallowing. The radial forearm free flap provides an excellent skin paddle, with adequate surface area and thickness. Objectiveto compare morbidity and aesthetic outcomes of fullthickness skin grafts ftsgs and splitthickness skin grafts stsgs in the reconstruction of the. Page 2 of 5 your hospital stay after radial forearm free flap surgery uwmc otolaryngology head and neck surgery center box 356161 1959 n. A fullthickness paramedian forehead flap supplied external coverage. It is most often designed as a free flap but may be pedicled e. Radial forearm flap an overview sciencedirect topics. Free radial artery forearm flap in reconstruction of oral. Second free radial forearm flap for urethral reconstruction after partial flap necrosis of tube. After ensuring good flap uptake and adequate primary healing, the flap was debulked and reshaped at 4 months after inset.
Squamous cell carcinoma of the tongue is a highly malignant condition. Harii described the use of a tubed fasciocutaneous free flap for pharyngoesophageal reconstruction in 1985. Based on this experience, if a radial forearm free flap is our preferred method of reconstruction and the patient presents with an abnormal allens test, we will use an alternative method of reconstruction, be it the opposite radial forearm or another fasciocutaneous flap, rather than rely on angiography results. Pdf tissue expansion of radial forearm free flap donor. Osteocutaneous radial forearm flap free tissue transfer. Reconstructing forearm free flap donor sites using full. Radial forearm flap free suprafacial suprafascia donor morbidity safety reliability technique method. The flap is based on the axis of the radial artery. Unsubscribe from microsurgery made easy cancel unsubscribe.