Free radial forearm osteocutaneous perforator flap for reconstruction of total nasal defects

A case in which a radial forearm osteocutaneous perforator flap was successfully transferred for one-stage reconstruction of total nasal loss is described. This thin flap consists of vascularized radial bone, superficial adiposal tissue, and no deep fascia. It is nourished by a single perforator of the radial artery and a cutaneous vein. The advantages of this flap are minimal donor-site morbidity, easy reconstruction for preservation of the radial arterial system, and no need for longer dissection through the radial artery. The donor defect can be repaired with a flow-through flap, such as an anterolateral thigh flap or a latissimus dorsi perforator flap.