Evaluation of Donor Site Function and Morbidity of the Fasciocutaneous Radial Forearm Flap

Bree, Remco de; Hartley, Chris; Smeele, Ludwig E.; Kuik, Dirk J.; Quak, Jasper J.; Leemans, C. René

doi:10.1097/01.mlg.0000147931.29261.18

Cited by 71 publications

(77 citation statements)

References 14 publications

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“…flaps, and more complex advancement techniques 6,8,[10][11][12]17,21,65 ( Figure 6). Release of the first web space in symbrachydactyly can be more challenging than similar releases done for other diagnoses due to a lack of local skin available.…”

Section: Syndactyly and Web Contracturementioning

confidence: 99%

Symbrachydactyly

Goodell

Bauer

Sierra

et al. 2016

Hand (New York, N,Y.)

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Background: Symbrachydactyly is a unilateral congenital hand malformation characterized by failure of formation of fingers and the presence of rudimentary digit nubbins. The management is variable and are investigated in this review. Methods: a detailed review of the literature was compiled into succinct clinically relevant categories. Results: Etiology, classification, non-surgical management, surgical intervention, and patient oriented outcomes are discussed. Conclusions: all interventions should prioritize realistic, evidence-supported appearance and functional gains. Studies of the baseline function and quality of life of children with symbrachydactyly would allow surgeons to better understand functional changes associated with various interventions and would help surgeons and parents to make the best treatment decisions.

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Section: Syndactyly and Web Contracturementioning

confidence: 99%

Symbrachydactyly

Goodell

Bauer

Sierra

et al. 2016

Hand (New York, N,Y.)

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“…RFF flaps have been found to have widely varying effects on hand function, [4][5][6][7][8][9][10][11] but studies of their effect on upper extremity function are few and have failed to take into consideration the possible effect of neck dissection. 4,5,8,9 The aim of the present prospective matched-pair study was to determine the effect of the RFF flap on upper extremity function.…”

Section: Introductionmentioning

confidence: 99%

Upper extremity morbidity after radial forearm flap harvest: a prospective study

et al. 2013

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Objective: To determine the effect of radial forearm free (RFF) flap harvest on patient-reported postoperative upper extremity disability. Methods: Patients undergoing RFF flap reconstruction following resection of head and neck cancer were recruited and matched with similar patients undergoing non-RFF reconstruction. All subjects completed the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire preoperatively and at least 1 year postoperatively. Results: Postoperative DASH scores were significantly higher (more severe disability) in patients undergoing RFF flap reconstruction (6.93 AE 5.54; n ¼ 52) compared with those undergoing non-RFF flap surgeries (2.95 AE 4.42; n ¼ 52). Preoperative DASH score, flap size, patient age and tumour stage were significantly correlated with postoperative DASH score. Conclusion: Excluding the effect of neck dissection, RFF flap reconstruction has a significant deleterious effect on upper extremity function.

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“…All these tissues can be transferred with the blood supply of the radial artery and its concomitant veins, cephalic veins and sometimes the basilic vein to reconstruct head and neck defects. 6 In addition, the flap should include two sensory nerves: the lateral antebrachial cutaneous nerve and a branch of the medial antebrachial cutaneous nerve. Depending on the need for tissue to cover facial defects, a flap 14-16 cm wide by 15-18 cm long can be designed.…”

Section: Discussionmentioning

confidence: 99%

“…11 It was shown, through a questionnaire, that a prior conversation with the patient explaining the technique, with its advantages and disadvantages, may reduce complaints caused by the aesthetic impact of scars in the forearm. 6,12 The myocutaneous rectus abdominis free flap can be transversely (TRAM flap), vertically (VRAM flap) or obliquely designed. Although rectus abdominis flaps are often not transversal, but vertical (VRAM) or oblique, they are still known as "free TRAM flaps."…”

Section: Discussionmentioning

confidence: 99%

Free flaps in Surgical Dermatology: comparison between fasciocutaneous and myocutaneous free flaps in facial reconstructions

Camacho‐Martínez¹,

Rollón

Salazar

et al. 2011

An. Bras. Dermatol.

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BACKGROUND: Dermatologic surgeons routinely harvest pedicled flaps at distance with an axial or random pattern to repair facial defects. These types of skin flaps are time-consuming and have high economic, social and personal costs. These drawbacks could be avoided with the introduction of a single-step transfer of free flaps to the recipient site, with microvascular anastomosis. OBJECTIVE: To demonstrate that better results are obtained with myocutaneous or fasciocutaneous free flaps and which one is more suitable in surgical dermatology. MATERIAL AND METHODS: We selected two patients of opposite sexes and similar ages who had undergone Mohs surgery to remove recurrent malignant tumors that were located in the upper cheek bordering the zygomatic zone. The woman was treated with a fasciocutaneous radial free flap and the man with a rectus abdominis free flap. RESULTS: Both patients had excellent immediate postoperative outcomes. Complications observed in the male patient were related to a previous pulmonary alteration. The fasciocutaneous radial free flap reconstruction was easier to perform than the rectus abdominis free flap; nevertheless, the radial free flap is very thin and, although the palmaris longus tendon is used, it does not yield enough volume, requiring later use of implants. In contrast, the rectus abdominis free flap transfers a wide flap with enough fat tissue to expand in the future. As for the cosmetic results regarding the donor site, the rectus abdominis free flap produces better-looking scars, since secondary defects of the palmar surface cannot be directly closed and usually require grafting -a situation that some patients do not accept. CONCLUSIONS: In surgical dermatology, each case, once the tumor has been extirpated, requires its own reconstructive technique. The radial free flap is suitable for thin patients who are willing to cover their arm with a shirt. The rectus abdominis free flap is best suited for obese patients with deep and voluminous defects, although it is necessary to dislocate the navel from its original position. Keywords: Mohs surgery; Muscle development; Surgical flaps Resumo: FUNDAMENTOS: Os cirurgiões dermatológicos habitualmente realizam retalhos pediculados cutâneos à distância, de padrão axial ou ao acaso, para reparar os defeitos faciais. Estes tipos de retalhos cutâneos requerem muito tempo para realizar-se e têm elevadas despesas econômicas, sociais e pessoais. Com a introdução da transferência em uma única etapa de retalhos livres ao local receptor, com anastomose microvascular, estes inconvenientes poderiam ser evitados. OBJETIVO: Demonstrar que se obtêm melhores resultados com retalhos livres fasciocutâneos ou miocutâneos e qual deles é mais adequado em Dermatologia cirúrgica. MATERIAL E MÉTODOS: Selecionamos dois pacientes, de sexos diferentes e idades similares, que haviam sido tratados com cirurgia de Mohs, para eliminar os tumores malignos recidivantes que se localizavam na parte superior das bochechas contatando com a zona zigomática. A mulher...

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Evaluation of Donor Site Function and Morbidity of the Fasciocutaneous Radial Forearm Flap

Abstract: There is a negligible objective morbidity of a free radial forearm flap harvest procedure, but a number of patients have subjective complaints when asked. Elaborate presurgical counseling can probably reduce these complaints.

Cited by 71 publications

References 14 publications

Symbrachydactyly

Symbrachydactyly

Upper extremity morbidity after radial forearm flap harvest: a prospective study

Free flaps in Surgical Dermatology: comparison between fasciocutaneous and myocutaneous free flaps in facial reconstructions

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