Closure of the Radial Forearm Donor Site Using a Local Hatchet Flap

Lane, Jennifer C E; Swan, Marc C.; Cassell, Oliver

doi:10.1097/sap.0b013e3182321ba0

Cited by 33 publications

(34 citation statements)

References 29 publications

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“…Lane et al () reported 45 cases of primary closure of free radial forearm donor site with advancement local flap based on ulnar artery perforators.…”

Section: Discussionmentioning

confidence: 99%

“…Skin grafting of a given flap's donor site can have negative functional and esthetic implications, and numerous attempts have been made in different body regions to provide a complete soft tissue restoration while avoiding skin grafting (Agostini & Lazzeri, 2012;Hallock, 2018;Lane, Swan, & Cassell, 2013). Among the various techniques reported in literature, perforator-based propeller flaps have also been successfully employed to address the secondary defect determined by the harvest of different types of flap (Iida, Yoshimatsu, & Koshima, 2017;Scaglioni, Barth, & Chen, 2018;Sharma et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

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Propeller flap donor site closure by means of another propeller flap: A case report and literature review

2019

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Despite some ongoing criticisms, propeller flaps are still gaining popularity among plastic surgeons. The need of skin grafting of the donor site is one of those limitations that sometime affect the beauty and the efficacy of this reconstructive technique. Similar to a classic bi‐lobed skin flap in which the second lobe of the same flap is mobilized to cover the donor site defect of the first lobe, a second, discrete propeller flap can be harvested adjacent to the first, in order to close the first donor site defect, thus avoiding the need for a skin graft. We applied this concept of “sequential” propeller flaps to cover a 4.5 × 4 cm full thickness soft tissue defect at the level of the heel in a 54‐year‐old patient who underwent melanoma excision and sentinel node biopsy.The first and second propeller flaps of 10 × 4.5 cm respectively were rotated on a distal and on a more proximal perforator of the posterior tibial artery (PTA) respectively, obtaining a tension free closure along the entire wound. The post‐operative course was uneventful and the patient returned to full normal activities after 4 weeks. Follow up at 6 months showed a stable reconstruction with no functional deficit. This option, that relies on two separate perforator propeller flaps performed in sequence to obtain complete wound closure, may be kept in mind when dealing with soft tissue defects eligible for propeller flap reconstruction, as long as sizeable perforators in a favorable position are available. Moreover, a brief literature review on propeller flap use in flap donor site closure is also provided.

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“…Lane et al () reported 45 cases of primary closure of free radial forearm donor site with advancement local flap based on ulnar artery perforators.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Propeller flap donor site closure by means of another propeller flap: A case report and literature review

2019

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“…[5][6][7] Direct closure would be the method of choice, but it is not often possible due to too large defects and/or insufficient skin laxity. 8 Several techniques have been described for an adequate closure of the donor-site defect following RFFF harvesting, such as purse-string closure, 9 split-thickness skin grafts, 10,11 full-thickness skin grafts, [12][13][14][15] tissue expansion, 16,17 closure with local flaps, [18][19][20] cross-suturing, 21 use of artificial dermis 22,23 and local fascial flaps. 24 Split-thickness skin grafts (STSGs) are most commonly used.…”

Section: Introductionmentioning

confidence: 99%

Closure of the Radial Forearm Free Flap Donor Site Using the Combined Local Triangular Full-Thickness Skin Graft

Moreno-Sánchez

González-García

Ruíz-Laza

et al. 2016

Journal of Oral and Maxillofacial Surgery

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“…5 To date, many options are available for closing the RFFF donor site without the need for an additional operative site. These included ipsilateral FTSG, 6 hinged radial forearm STSG, 7 ulnar perforator flap, 8 cross-suturing, 9 artificial skin graft, 10 tissue expander, 11 local hatchet flap, 12 and snake design RFFF flap. 4 In this manuscript, we describe a new technique for closing the RFFF donor site based on the use of a bilobed transposition flap and evaluate its effectiveness and safety.…”

Section: Introductionmentioning

confidence: 99%

Novel technique for the direct closure of the radial forearm flap donor site defect with a local bilobed flap

et al. 2019

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Background The donor site defect remains the major disadvantage of the radial forearm free flap (RFFF). The purpose of this case series was to evaluate the effectiveness and safety of a local bilobed flap in direct closure of the RFFF donor site defect. Methods Between February 2017 and July 2017, a prospective study was designed with 13 patients who had undergone RFFF reconstruction of the oral cavity. The primary purpose was to assess the effectiveness and safety of a bilobed flap closure of the RFFF donor site with primary healing. The late endpoint was to evaluate functional morbidity of the donor hand by comparing preoperative and postoperative outcomes. Results The donor site defect healed primarily in 12 of the 13 patients. A small area of skin necrosis (4%) developed in one patient, which was managed conservatively and healed by secondary intention. A significant reduction of wrist extension (mean difference [MD] = 2.64°, P = .01) and grip strength (MD = 3.68 kg, P = .04) was observed between preoperative and postoperative measurements. No statistically significant difference was observed regarding flexion, radial deviation, ulnar deviation, supination, pronation and pinch strength (P > .05). Conclusions The bilobed flap is a reliable and effective method for closure of a RFFF donor site defect, ≤5 cm in greatest length. The advantages are excellent regional skin color match and avoidance of a second donor site and its inherent complications.

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Closure of the Radial Forearm Donor Site Using a Local Hatchet Flap

Abstract: We recommend this technique of primary closure of the RFFF donor site: it is well tolerated by the patient, with good cosmesis and is associated with no discernable functional morbidity.

Cited by 33 publications

References 29 publications

Propeller flap donor site closure by means of another propeller flap: A case report and literature review

Propeller flap donor site closure by means of another propeller flap: A case report and literature review

Closure of the Radial Forearm Free Flap Donor Site Using the Combined Local Triangular Full-Thickness Skin Graft

Novel technique for the direct closure of the radial forearm flap donor site defect with a local bilobed flap

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