Tracheal reconstruction with a prefabricated and double-folded radial forearm free flap

We have described a prefabricated radial forearm free flap containing costal cartilage for tracheal reconstruction. The main advantages of this flap are that it requires only one piece of costal cartilage, simple cartilage trimming, and allows the possible reconstruction of both the internal lining and the external resurfacing when the flap itself is folded. This procedure is easy and its outcome is stable. This flap is an attractive option for the reconstruction of large tracheal and skin defects, even in areas previously exposed to surgery or irradiation.