Pretransfer expansion of a sensate lateral arm free flap

Tissue expansion as a reconstructive technique has gained widespread popularity in the field of plastic and reconstructive surgery since Radovan reported his original work in Boston in 1976. Reconstruction by free muscle or composite flaps transferred by microsurgery has preceded the use of tissue expansion. However, a combination of both modalities of reconstruction to fulfill particular reconstructive needs has not yet been reported. This article reports a case of a sensate lateral arm free flap that was expanded prior to its transfer to resurface a 12 X 18 cm defect of the ankle and foot in a child, with primary closure of the donor site. The initial successful resurfacing was followed by recovery of sensation in the entire flap over a period of six months, and the static two-point discrimination measured 9 to 11 mm, which was close to that of the corresponding area of the opposite arm. The child has resumed his sports activities with no problems over a one-year follow-up.