The free radial forearm flap--the management of the secondary defect

The secondary defect of the radial forearm flap is usually reconstructed with a split skin graft. This is applied to the visceral paratenon of several tendons in addition to muscle but early movement of the hand is often followed by breakdown, infection, delayed healing and reduced function. A technique for obtaining both full primary healing and full function is described which has produced good results in 16 patients.