Use of the medial upper arm skin as an arterialised flap

The skin on the underside of the upper arm is supplied in part by the superior ulnar collateral artery, a direct cutaneous artery arising from the brachial artery four to six cm distal to the pectoralis major insertion. Two-thirds to three-quarters of the length of the medial arm skin can be reliably transferred as an arterialized undelayed pedicle flap. This skin provides excellent coverage for the opposite hand from a relatively inconspicuous donor site. Transfer of this flap is safe and patient discomfort is minimal. It is recommended for elective reconstruction and emergency procedures.