The vascular basis of the radial forearm flap

The radial forearm flap is one of several valuable fasciocutaneous flaps. Therefore, its arterial and venous supply has been studied by dissection of 56 cadavers using various techniques, such as ink, latex, and barium sulfate injections. The relevant arterial branches tend to be in three groups with three associated and anastomosing perfusion zones. The blood supply of the distal radius is shown by latex injections. The vessels to tendons and nerves are briefly discussed. The flap is drained by superficial veins or radial artery venae comitantes or both. Each arterial perforator has one or two associated veins through which blood can pass into the venae comitantes. It is confirmed that the veins have valves, through which reverse flow has to occur in the pedicle of distally based island flaps. An explanation of how this is possible is given. The relevance of the findings to fasciocutaneous flaps in general is discussed.