The radial forearm flap is generally classified as a fasciocutaneous flap. For steps 15, see video, supplemental digital content 2, which demonstrates the surgical technique for elevation and inset of a radial forearm fasciaonly flap. Harii described the use of a tubed fasciocutaneous free flap for pharyngoesophageal reconstruction in 1985. Radial free forearm flap vula university of cape town. Ab the unique attributes of the radial forearm flap for head and neck reconstruction make it a primary choice from the reconstructive ladder. Modified karapandzic flap with radial forearm free flap to. Functional reconstruction of subtotal glossectomy defects. From 2005 to 2012, 20 radial forearm flaps were used to repair the defects. The radial forearm flap is a fasciocutaneous flap which has established its role in soft tissue reconstruction in the head and neck region as a free flap. The radial forearm free flap was inset in the scalp over a drain using interrupted sutures e. In 1978, a fasciocutaneous free flap from the volar aspect of the forearm and pedicled on the radial artery was first used in china.
Free radial forearm bunting flap for reconstructing softt. The radial forearm free flap is an underutilized free flap in the reconstruction of complex scalp defects. Radial forearm flap an overview sciencedirect topics. The role of the osteocutaneous radial forearm free flap in the treatment of mandibular osteoradionecrosis. Shortly after, this technique was popularized by different european. Radial forearm free flap rfff is a versatile reconstructive method, first described by yang et al. When this socalled chinese flap was originally described by yang et al.
Jan 22, 2016 osseocutaneous radial forearm free tissue transfer for repair of complex midfacial defects. Signed consent is on file at memorial hermann hospital and. Rfff has two major venous outflow systems, superficial and deep vein. Clinical reliability of radial forearm free flap in repair. Use of the radial forearm microvascular freeflap graft. Reconstruction of scalp defects with the radial forearm free flap. Your hospital stay after radial forearm free flap surgery. Nevertheless, other forearm flaps, less expensive in terms of vascular. Radial forearm free flap iowa head and neck protocols.
The radial forearm flap without fascia and other refinements. Among free flaps, the radial forearm free flap rfff has become one of the most commonly used by microvascular surgeons owing to its versatility and the ease of harvesting. Osteocutaneous radial forearm free flap harvest and. In order to reduce the congestion in the flap, an endtoend anastomosis between the distal end of the radial artery and the ipsilateral lingual vein was performed. Radial forearm free flap for soft palate reconstruction. Twelve patients were reconstructed using a free radial forearm flap and 14 with an anterolateral thigh flap. Radial forearm free flap is the most reliable flap for intraoral soft tissue reconstruction after cancer ablation surgery.
Free radial forearm flap how is free radial forearm flap abbreviated. Reconstruction of scalp defects with the radial forearm. It is one of the most common ways of replacing tissue in the head and. A, postoperative appearance 5 years after a radial forearm free flap donor site was. Jun 01, 2000 read radial forearm free flap for partial laryngopharyngectomy, operative techniques in otolaryngologyhead and neck surgery on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. Case report survival of a free radial forearm flap without venous. The radial forearm flap is usually used in reconstruction of the mutilated hand as a reverse pedicled flap, but occasionally, a free radial forearm flap can be harvested from the contralateral forearm. Despite the increasing development of thin perforator flaps and continuous sophistication of flapraising techniques at nearly any donor site of the body, the rff remains the most commonly used free flap, mostly raised as a standard fasciocutaneous. This piece of writing comprised all the detail about harvesting radial forearm free flap, advantages, disadvantages. Potential disadvantages of the radial forearm free flap for palatal closure include donor site morbidity, graft bulk, difficulty retaining a prosthesis due to a lack of a mucosal barrier, lack of bone for implant reconstruction, and risk of free flap failure. The reverse radial forearm flap potentially offers thin, mobile skin with similar characteristics to the skin.
Pdf folded free radial forearm flap for reconstruction of full. A comparison of the donorsite morbidity after using the. The reverse radial forearm rrf flap can be used to cover moderatesized defects. Figure 2 omitted in 1981, yang et al in china became the first to describe the radial artery forearm free flap, which is also known as the chinese flap. Learn about the free radial forearm flap, an online 3dvideobased course, accredited by the royal college of surgeons of england. Preoperative testing for radial forearm free flaps to reduce. Free radial artery forearm flap in reconstruction of oral cavity cancers our experience 88 int j res med. Doublelayered collagen graft to the radial forearm free. Read radial forearm free flap for partial laryngopharyngectomy, operative techniques in otolaryngologyhead and neck surgery on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. Large studies have demonstrated their safety and efficacy, with 93% 1 and more recently 96. Thirteen patients achieved an oral diet, while 2 patients remained dependent on tube feeding.
What is the abbreviation for radial forearm free flap. A subcutaneous tunnel was created to access the temporal vessels c. Radial artery forearm free flap how is radial artery forearm free flap abbreviated. Radial forearm free flap for partial laryngopharyngectomy. Single stage reconstruction of fullthickness defects of the cheek with the folded free radial forearm flap is reliable and produces. Longterm functional donor site morbidity of the free. Free radial artery forearm flap in reconstruction of oral. Monitoring the free radial forearm flap in pharyngooesophageal. Radial forearm free flap is regularly used in reconstruction of oral and maxillofacial region after ablative cancer surgeries.
Within the period the flap established itself as a free flap particularly in head and neck reconstruction2,3. Militsakh on, wallace di, kriet jd, tsue tt, girod da. This study evaluates various microvascular free flap reconstructions in this patient population, including the rarely utilized radial forearm free flap. We analyzed the superiority and reliability of the flap. A radial forearm free flap is one way of filling a hole which is left when a cancer has been removed. The flap was transferred, like bunting, to the injured hand with an exteriorized pedicle. Radial forearm free flap what is a radial forearm free flap. The dominant pedicle is the radial artery, with venous outflow through the dual system of the venae comitantes and cephalic vein. Radial forearm free flap postoperative instructions. After approval from the ethical committee, confirmed agreement of the donor and the patients guardian, a radial forearm free flap was transplanted from an abo compatible mother to her 5 year old daughter with xp. Tissue defect reconstruction using radial forearm free flap rfff is a common surgical technique whose success or failure is mainly. Free radial forearm flap how is free radial forearm flap. Drainage methods include combining both systems or using one alone. This elearning course provides a step by step approach, lessons on objectives, preoperative information and postoperative complications, procedural anatomy and a test.
The radial forearm flap in reconstruction of upper limb. Radial forearm free flap free download as powerpoint presentation. Rafff is defined as radial artery forearm free flap very rarely. Nov 22, 2011 radial forearm free flap rfff is a versatile reconstructive method, first described by yang et al. The aim of the present study is to assess functional outcomes after hemiglossectomy and microvascular reconstruction. This is surgery that removes a piece of skin from your inner forearm and uses it to replace tissue that was removed due to cancer. Flap choice should be dictated by the needs of the patient and those of the site to be reconstructed. Use of radial forearm free flaps in oncologic surgery of the head and neck use of radial forearm free flaps in oncologic surgery of the head and neck gapany, markus 20000901 00. Page 1 of 5 your hospital stay after radial forearm free flap surgery uwmc otolaryngology head and neck surgery center box 356161 1959 n. Doctors often use this surgery to reconstruct an area in the head and neck. Download as an information leaflet pdf radial forearm flap. The patient did not complain about the appearance and function of the left forearm. Revisiting radial forearm free flap for successful venous. Monitoring the viability of the free radial forearm flap after pharyngo oesophageal.
Reverse radial artery forearm flap in a case of giant hairy nevus of. The radial forearm flap was first developed in china as a fasciocutaneous flap over thirty years ago1,2. Surgical technique ottie van zyl the radial free forearm flap rfff was one of the first free tissue transfer flaps to be described. The ulnar forearm flap has the advantages of thin and pliable skin, constant and large pedicle, and the teclinical possibility of combination with the muscles, sensory or motor nerve, and ulna.
Rfff abbreviation stands for radial forearm free flap. Jan, 2014 to assess the functional donor site morbidity of the forearm free flap in patients surviving at least 2 years after ablative head and neck cancer surgery in a tertiary care centre. We report a modified technique of folding the radial forearm flap for. Sep 01, 2000 use of radial forearm free flaps in oncologic surgery of the head and neck use of radial forearm free flaps in oncologic surgery of the head and neck gapany, markus 20000901 00. Its main virtue as a free flap is as a result of its predictable, large and long pedicle that greatly facilitates micro vascular anastomosis1. As cadaveric organs are unavailable in our country. Preoperative testing for radial forearm free flaps to. Free flaps did not, however, become widely used for hypopharyngeal reconstruction until after the refinement of microvascular techniques during the 1970s. Its value as a useful flap in soft tissue reconstruction in upper limb injuries has also been recognized. Free radial forearm bunting flap for reconstructing soft. The radial free forearm flap rfff was one of the first free tissue transfer flaps. Twentysix patients underwent primary tongue microvascular reconstruction after hemiglossectomy.
The ideal method for buccal defects should provide good outcome of both function and appearance. Free radial forearm flap after partial glossectomy for squamous cell carcinoma of the tongue chuah uc,kamarul t,sara t department of orthopaedic surgery,university of malaya medical centre,50603 kuala lumpur,malaysia abstract. We report the use of a free radial forearm flap with multiple perforatorbased skin islands for the reconstruction of complex softtissue defects involving multiple fingers. The skin of the volar forearm provides relatively thin and reliable coverage for a wide variety of defects. Nevertheless, other forearm flaps, less expensive in terms of vascular involvement 59. Modified karapandzic flap with radial forearm free flap to reconstruct a large composite upper lip and palate defect. A radial forearm flap is then used to cover the muscle of the flap as well as the defect in the lateral. The skin of the forearm is, however, supplied by branches from the radial artery. Several types of free flaps can be used to restore defects within the oral cavity and orohypopharynx anterolateral thigh flap, rectus abdominis musculocutaneous flap, free deltoid flap, etc. Free radial forearm flap failure due to unautonomization in a 105year old patient. It is one of the most common ways of replacing tissue in the head and neck, particularly after mouth cancers have been removed. The mother had an older daughter died from the same disease at the age of 14. Indications the forearm flap has been used for just about everything imaginable in the area of head and neck reconstruction.
Longterm functional donor site morbidity of the free radial. Yang guofan, chen baoqui, gao yuzhi 1981 free transfer of forearm flap. A subfascial dissection of the radial forearm flap was performed with preservation of the radial nerve b. Advanced and recurrent cutaneous squamous cell carcinoma of. If you dont have a registration, then register for. Radial artery forearm free flap how is radial artery. Comparing it with the radial forearm flap, there is no possibility of exposure of flexor tendons, which usually results in the good take of skin grafts. Rafff radial artery forearm free flap acronymfinder. Radial forearm free flap musculoskeletal system medicine. Osteocutaneous radial forearm flap free tissue transfer. However, unesthetic scar of the donor site and the need for a second donor site for skin graft are major disadvantages of the forearm flap. The purpose of this study was to report the clinical results of doublelayered collagen graft to the donor site of the forearm free. The mission of the ahns is to advance education, research, and quality of care for the head and neck oncology patient.
Living related hemiface skin transplant using radial. Gottleib lj, tachmes l, pielet rw 1993 improved venous drainage of the radial artery forearm free flap. The radial forearm free flap rfff has been widely used as a reliable reconstructive solution as it provides thin soft tissues, particularly useful to reconstruct the oral cavity and other head. Because the radial aspect of the arm is hair bearing, the amount and quality of the hair is a consideration in using this flap for resurfacing. Singlestage reconstruction of fullthickness defects of the cheek with the folded free radial forearm flap is reliable and produces. The harvested radial forearm free flap measured 6 x 12 cm d.
Reconstruction of scalp defects with the radial forearm free. Clinical reliability of radial forearm free flap in repair of. Functional reconstruction of subtotal glossectomy defects with radial forearm free flap. Advanced and recurrent malignancies of the scalp are aggressive and challenging to treat. Functional results of microvascular reconstruction after. Free radial forearm flap failure due to unautonomization. It has since become a workhorse for soft tissue replacement in head. Radial forearm free flap pharyngoesophageal reconstruction.
Microvascular surgery protocols general considerations. The radial forearm free flap should not be used for every head and neck defect. Our results have been very satisfactory in this small series. This study involved nine longterm survivors 2 year postoperative who had forearm free flaps to reconstruct head and neck defects. Monitoring the viability of the free radial forearm flap after pharyngooesophageal.
Paniello, md the method of closure of the partial laryngopharyngectomy plp defect can have a profound affect on all three functions of the larynx. Revisiting radial forearm free flap for successful venous drainage. Unsubscribe from microsurgery made easy cancel unsubscribe. Squamous cell carcinoma of the tongue is a highly malignant condition. Doublelayered collagen graft to the radial forearm free flap. Reconstruction of the cranial base after resection of complex lesions requires creation of both a vascularized barrier to cerebrospinal fluid csf leakage and tailored filling of operative defects.
If the inline pdf is not rendering correctly, you can download the pdf file here. We have used the radial forearm free flap for soft palate reconstruction in 15 patients treated for cancer of the oropharynx during the past 42 months. Tissue defect reconstruction using radial forearm free flap rfff is a common surgical technique whose success or failure is mainly dependent on venous drainage. To assess the functional donor site morbidity of the forearm free flap in patients surviving at least 2 years after ablative head and neck cancer surgery in a tertiary care centre. Radial forearm flap british association of oral and. Radial forearm flap microsurgery made easy loading. Osseocutaneous radial forearm free tissue transfer for repair of complex midfacial defects. Research open access reconstruction of scalp defects with the radial forearm free flap larissa sweeny1, brendan eby1, j scott magnuson1, william r carroll1 and eben l rosenthal1,2 abstract background.
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