The free forearm flap--a report of 25 cases

In 25 cases using microvascular techniques, free forearm flaps were used for reconstruction of various tissue defects. 15 flaps were used for repair of hand injuries, 5 for facial defects, 1 for lower extremity deformity and 4 for total rhinoplasty. All flaps survived. The arterial blood supply of the forearm flap comes from the cutaneous branches of the radial artery while its venous drainage is via cephalic vein and the radial comitantes veins. The forearm flap has a thin layer of subcutaneous fatty tissue, can provide quite large area of soft tissue and the vascular pedicle is long with moderately large calibre vessels. The donor area, however, has to be skin grafted, leaving an unsightly scar over the forearm which is one of the shortcomings of this flap. Secondly it means sacrificing a major arterial supply to the hand on the donor side.