Transillumination method for intraoperative mapping subfascial plexus of free-style radial forearm flap

Without well recognizing the vascular territories of the perforator, it might damage the pedicle and diminish the survival of the flap. This study described a transillumination method for intraoperative mapping of subfascial plexus of the perforator in radial forearm flap and also compared the perioperative outcomes and complications of the method with the standard folded, bipaddled forearm flap in head and neck reconstruction.

Between January 2011 and December 2017, we applied the transillumination method in 12 patients who underwent head and neck reconstruction with forearm flaps immediately after surgical resection of oral cancer (case group). For comparison, we identified 12 age- and gender-matched patients who received head and neck reconstruction with folded, bipaddled radial forearm flaps (control group). Demographic factors, diagnosis, flap size, perioperative data, and postoperative complications were compared between the two groups.

There was no significant difference in harvesting time, operative time, or blood loss between the case and control groups. No patient experienced donor-site complication. There was no significant difference in recipient-site complication between the case and control groups.

The transillumination method can allow plastic surgeons to easily identify the perforator vascular plexus of the radial forearm flap, which facilitates intraoperative flap design in head and neck reconstruction without increasing harvesting time and risk of postoperative complications.