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Bipaddle radial forearm flap for head and neck reconstruction
Yi Xin Zhang1, Wenjing Xi, Davide Lazzeri
1From the *Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University, School of Medicine, Shanghai, China; †Plastic Reconstructive and Aesthetic Surgery Unit, Villa Salaria Clinic, Rome, Italy; ‡Division of Head and Neck Surgery, Department of Surgery, Hunan Province Tumor Hospital, Changsha, Hunan, China; §Plastic and Reconstructive Surgery Unit, University of Rome "Tor Vergata"; ∥Division of Plastic, Reconstructive, Maxillofacial, and Oral Surgery, Department of Surgery, Duke University Medical Center, Durham, NC; and ¶Department of Plastic and Reconstructive Surgery, Marche Polytechnic University Medical School, University Hospital of Ancona, Ancona; and #Maxillofacial Surgery Unit, Hospital of Florence, Florence, Italy.
The bipaddle radial forearm (RF) flap offers a solution for head and neck reconstruction, avoiding skin grafts at the donor site. This technique provides excellent cosmetic and functional outcomes for patients.
Area of Science:
- Plastic Surgery
- Head and Neck Surgery
- Reconstructive Surgery
Background:
- Radial forearm (RF) free flap is a common choice for head and neck reconstruction.
- Donor site skin grafting in RF flaps leads to contour deformities and poor appearance.
- Technical modifications aim to improve RF flap outcomes.
Purpose of the Study:
- To report a clinical series using the bipaddle RF flap.
- To evaluate the efficacy of the bipaddle RF flap in head and neck reconstruction.
- To assess donor site healing and recipient site outcomes.
Main Methods:
- The bipaddle RF flap technique involves a longer, narrower skin island split into two paddles.
- Each paddle is supplied by independent perforators from the radial artery.
- This design facilitates direct closure of the donor site and allows shape customization via the "perforator-pedicle propeller flap method".
Main Results:
- The bipaddle RF flap was used in 11 head and neck cancer reconstruction cases.
- Defects were located in the tongue (7) and intraoral region (4).
- All patients experienced uneventful healing with excellent cosmetic and functional results after a mean 20-month follow-up.
Conclusions:
- The bipaddle RF free flap is a reliable and versatile option for head and neck soft tissue defects.
- It allows for customized resurfacing due to variability in shape and size.
- Primary closure of the donor site eliminates the need for a secondary skin graft.
