Flap course day 1 Omdurman teaching hospital Radial artery forearm flap

Flap course day 1
Omdurman teaching hospital
Radial artery forearm flap

It can be used as an island-skin flap, a free flap or as a compound forearm flap including vascularised nerve, bone or tendons.

The Radial Forearm Flap

Skin and fascia: optional tendon and bone

Innervation: No.

Blood supply: Radial artery and perforators from the radial artery.

Artery: Large caliber artery.

Vein(s): The venae of the radial artery can be small. The subcutaneous venous system or cephalic vein can be used for drainage, making for a larger caliber vessel.

Pedicle length: Can be dissected up to the takeoff from the brachial artery just distal to the antecubital fossa.

The course of the radial pulse is determine and the flap is outlined over the radial artery. The position of the flap can be pushed radially, ulnarly, or more proximally depending on the needs of the recipient area. Consideration should be given to the location of the cephalic vein if that is to be used for venous drainage.

The success of the RRFF flap depends on cutaneous perforators and the septocutaneous perforators.

Radial Forearm Osteocutaneous Flap: a segment of the radius can be harvested with the flap, in congruity with a portion of FPL muscle. It must be a unicortical block of volar radius, and no wider than 1.5 centimeters. The radius is prone to fracture is a segment of radius is harvested.

The reverse radial forearm fascial (RRFF) flap is widely used in the hand coverage in distal soft-tissue reconstruction . The traditional RRFF flap incorporates the radial artery from the forearm and is perfused by retrograde flow through the palmar arch.

 However, to produce this flap, a major artery to the hand must be sacrificed, which compromises the viability of the hand and may lead to ischemia. Some authors have recommended reconstructing the radial artery with a vein graft in a RRFF flap

Author: Terance (Terry) Ted Tsue, MD; Chief Editor: Arlen D Meyers, MD, MBA