Forearm arterial loop as an expedient source for inflow to upper extremity free flaps

Challenging wounds of the upper extremity requiring free tissue transfers are relatively infrequent. As a direct consequence, methods to access recipient vessels or acceptable alternatives may not be as familiar as in the lower extremity. In rare circumstances, creation of an arterial loop by elevation of a portion of either major forearm artery provides an easily accessible, pristine source of inflow for a planned free flap matching vessels of comparable caliber. Such a maneuver may also be important to ensure preservation of optimal hand function by avoiding any dissection in the vicinity of essential musculotendinous and neurovascular structures that might reside within or adjacent to the zone of injury.