Radial Forearm Free Flap: A Modified Technique for Procurement as a Sentinel Skin Flap

Area of Science:

• Transplantation surgery
• Surgical techniques
• Immunology

Background:

• Organ rejection is a significant hurdle in solid organ transplantation.
• Sentinel skin flap (SSF) offers early detection of organ rejection.
• Radial forearm free flap (RFFF) is a known technique for SSF procurement.

Purpose of the Study:

• To present a modified RFFF procurement technique for SSF during organ donation procedures (ODPs).
• To simplify and expedite SSF procurement for logistical and financial benefits.
• To enable surgeons unfamiliar with the traditional RFFF technique to perform SSF procurement.

Main Methods:

• Modification of the traditional RFFF procurement technique using deceased donor models.
• Development of an SSF technique specifically for ODPs.
• Standardized arm positioning and donor-site closure techniques were employed.

Main Results:

• The modified technique allows SSF procurement within 40 minutes.
• Optimized arm positioning maintained a sterile field and did not interfere with other teams.
• Running sutures ensured effective donor-site closure and cosmetic results.

Conclusions:

• A simplified, quicker, and safer modified RFFF technique for SSF procurement in ODPs has been developed.
• This technique is reproducible and can be performed by surgeons without prior RFFF experience.
• The modified procedure integrates seamlessly with organ procurement, avoiding interference.