Experience with the forearm septofascial flap

Abstract

Fascia has a well vascularized surface, and when it is covered with a split skin graft, it provides the thinnest possible flap. The authors present their own experience with the use of the forearm septofascial flap in 23 patients. A free septofascial flap was used in 15 patients and an island flap in 8 patients. Seven days later, only 25% of the patients had complete take of the split skin graft, while in 60% of the cases, there was only partial take of the graft. The results at 6 months, regarding appearance of the flap and donor site, were good. In 2 patients, a composite osteofascial flap was used for reconstruction of the mandible. In those patients, the viability of the bone was assessed with scintigraphy. There were no significant complications with the donor site. The forearm septofascial flap proved to be a good and reliable method of reconstruction in those parts of the body where thin cover was required. Constant anatomy and minimal postoperative complications are great advantages of the forearm septofascial flap when compared with other fascial flaps.A large number of assorted free flaps are now available for use in plastic and reconstructive surgery. Unfortunately, the results are not always satisfactory, particularly in areas with thin, soft tissue cover, e.g. hand, lower leg and foot. Even very thin flaps are sometimes too bulky in such cases.Fox [12] and Erol [9] described a method of vascularizing skin grafts using temporalis fascia which was then pedicled as a flap. Smith [32] and Brent [4] used fascia in combination with a free skin graft for reconstruction

Emergency rectus abdominis free flap coverage of the hand

“…The circumferential defect measuring 24 x 9 cm could not be covered by a reversed fasciocutaneous [12] or grafted septofascial [15] forearm flap because the exposed radial and ulnar arteries could have induced palmar arch thrombosis with subsequent flap loss. Also, the venous drainage via venae comitantes was not considered safe.…”