Shape-modified radial forearm flap: does it still have a role in upper extremity reconstruction?

Area of Science:

• Plastic Surgery
• Microsurgery
• Reconstructive Surgery

Background:

• Radial forearm flap harvesting traditionally involves the radial artery, leading to significant donor site morbidity.
• Recent anatomical discoveries highlight constant radial artery perforating vessels, enabling flap subdivision.
• This anatomical understanding facilitates the creation of shape-modified flaps for diverse recipient sites, minimizing donor site complications.

Purpose of the Study:

• To evaluate the efficacy and safety of shape-modified radial forearm flaps in upper extremity reconstruction.
• To assess the functional and aesthetic outcomes of this reconstructive technique.
• To determine the impact on donor site morbidity and patient well-being.

Main Methods:

• Eight pedicled or free shape-modified radial forearm flaps were utilized for upper extremity defect reconstruction between 2014 and 2018.
• Surgical techniques and patient prognoses were meticulously examined.
• Outcomes were quantitatively assessed using the Vancouver Scar Scale for skin and scar quality, and the Disabilities of the Arm, Shoulder and Hand score for function and symptoms.

Main Results:

• A mean follow-up of 39 months revealed no instances of flap necrosis.
• No cases of impaired hand circulation or cold intolerance were reported post-operatively.
• The technique proved reliable with acceptable functional and aesthetic results in the selected patient cohort.

Conclusions:

• The shape-modified radial forearm flap, though not novel, is underutilized among hand surgeons.
• This reconstructive method is reliable and yields acceptable functional and aesthetic outcomes in carefully selected cases.
• The technique offers a valuable alternative for upper extremity reconstruction with reduced donor site morbidity.