The ulnar artery free flap: the first 7 years

This paper reviews 7 years of experience with the ulnar artery free flap at the Wellington Regional Plastic Surgery Unit. It has become the free flap we use most commonly to repair defects after resection of intraoral cancers, other head and neck defects, and soft-tissue defects of the lower limbs. Of 56 attempted cases, 52 have been successful. Two procedures were abandoned intraoperatively because of abnormalities in vascular pattern, and 2 failed in the lower limb because of anastomotic failure. These 4 cases occurred early in the development of the technique; all cases in the last 4 years have been successful. The ulnar artery free flap has some important advantages over the radial artery free flap, including ease of donor site repair, cosmetic acceptability, and hairlessness.