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Radial Forearm Flap

  • R. PelliniEmail author
  • M. Ghirelli
  • F. Ferreli
  • B. Pichi
  • G. Mercante
  • G. Molteni
Chapter

Abstract

The radial artery is located in the lateral intermuscular septum which separates the flexor and extensor compartments of the forearm. Its superior half runs deep between the brachioradialis muscle and rotundum pronator muscle and its lower half between the tendons of brachioradialis and flexor radial carpalis. Along its course, the radial artery gives rise to 9–17 septocutaneous branches to supply the overlying fascia and skin. All these ramifications, with an average diameter of 0.5 mm, form a rich network of vascularization in subcutaneous layers, along with the fasciocutaneous ramifications of the ulnar, brachial, and interosseous arteries. Radial forearm free flap (RFFF) is one of the most common flaps used in head and neck reconstruction. In this chapter, neurovascular anatomy and harvesting surgical technique of the RFFF are described. Moreover, analitycal factors and technical considerations about RFFF are deeply discussed.

References

  1. 1.
    Henker DD, et al. Perforator anatomy of the radial forearm free flaps versus the ulnar forearm free flap for head and neck reconstruction. Int J Oral Maxillofac Surg. 2016;45(8):955–9.Google Scholar
  2. 2.
    Song R, Gao Y, Song Y, Yu Y, Song Y. The forearm flap. Clin Plast Surg. 1982;9(1):21–6.Google Scholar
  3. 3.
    Ichinose A, Tahara S, Terashi H, Yokoo S, Nakahara M, Hashikawa K, Kenmoku K. Importance of the deep vein in the drainage of a radial forearm flap: a haemodynamic study. Scand J Plast Reconstr Surg Hand Surg. 2003;37(3):145–9.CrossRefGoogle Scholar
  4. 4.
    Futran ND, Stack BC Jr. Single versus dual venous drainage of the radial forearm free flap. Am J Otolaryngol. 1996;17(2):112–7.CrossRefGoogle Scholar
  5. 5.
    Gottlieb LJ, Tachmes L, Pielet RW. Improved venous drainage of the radial artery forearm free flap: use of the profundus cubitalis vein. J Reconstr Microsurg. 1993;9(4):281–4; discussion 284–5.CrossRefGoogle Scholar
  6. 6.
    Boutros S, et al. Neural anatomy of the radial forearm flap. Ann Plast Surg. 2000;44(4):375–80.CrossRefGoogle Scholar
  7. 7.
    Kim JH, Rho YS, Ahn HY, Chung CH. Comparison of sensory recovery and morphologic change between sensate and nonsensate flaps in oral cavity and oropharyngeal reconstruction. Head Neck. 2008;30(8):1099–104.CrossRefGoogle Scholar
  8. 8.
    Namin AW, Varvares MA. Functional outcomes of sensate versus insensate free flap reconstruction in oral and oropharyngeal reconstruction: a systematic review. Head Neck. 2016;38(11):1717–21.CrossRefGoogle Scholar
  9. 9.
    VanderWilde RS, Wood MB, Zu ZG. Hand replantation after 54 hours of cold ischemia: a case report. J Hand Surg Am. 1992;17(2):217–20.CrossRefGoogle Scholar
  10. 10.
    Shonka DC, et al. Suprafascial harvest of the radial forearm flap decreases the risk of postoperative tendon exposure. Ann Otol Rhinol Laryngol. 2017;126(3):224–8.CrossRefGoogle Scholar
  11. 11.
    Schwarzer C, et al. Donor site morbidity and flap perfusion of subfascial and suprafascial radial forearm flaps: a randomized prospective clinical comparison trial. J Craniomaxillofac Surg. 2016;44(9):1299–304.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • R. Pellini
    • 1
    Email author
  • M. Ghirelli
    • 2
  • F. Ferreli
    • 1
  • B. Pichi
    • 1
  • G. Mercante
    • 3
  • G. Molteni
    • 4
    • 5
  1. 1.Department of Otolaryngology-Head and Neck SurgeryIRCCS “Regina Elena” National Cancer InstituteRomeItaly
  2. 2.Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital of ModenaModenaItaly
  3. 3.Otorhinolaryngology Unit, Humanitas Clinical and Research Center-IRCCSHumanitas UniversityRozzanoItaly
  4. 4.Department of Otorhinolaryngology-Head and Neck SurgeryUniversity Hospital of Verona Borgo TrentoVeronaItaly
  5. 5.Department of Surgery, Dentistry, Paediatrics and GynaecologyUniversity of VeronaVeronaItaly

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