Neurocutaneous axial island flaps in the forearm: anatomical, experimental and preliminary clinical results

The neurocutaneous island flap is an axial flap composed of one vein and one nerve, the arterial vascularisation of which is provided by the vascular plexus around and inside the nerve. The vascularisation of the lateral and medial cutaneous nerve of the forearm was studied in twenty fresh human upper limbs. In ten rats the vascularisation of these nerves was studied using latex injection and in twenty other animals neurocutaneous island flaps were raised based on the lateral forelimb cutaneous nerve and the medial cutaneous nerves of the forelimb. There was always a consistent arterial longitudinal plexus along the human and animal nerves, which linked the cutaneous perforating arteries. All the experimental flaps harvested survived well. On the basis of these anatomical and experimental findings neurocutaneous island flaps were raised on the forearms of three patients and are reported on.