Reducing Morbidity in the Radial Forearm Flap Donor Site

Bardsley, A.F.; Soutar, David S.; Elliot, David; Batchelor, A.G.; Hallock, Geoffrey G.

doi:10.1097/00006534-199008000-00015

Cited by 79 publications

(145 citation statements)

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“…We observed no functional limitations on daily life activities, a pain-free aesthetically acceptable scar and unaffected bone health. These results are consistent with previous publications, which, with shorter follow-up, also observed a minimal functional loss [4,9,[26][27][28] and a pain-free donor site [4,26]. However, morbidity of the donor-site arm after RFF has also been reported to be higher, including poor wound healing [8,11], bone fracture [5,6,11], persisting pain [12], or varying degrees of functional loss [7,[10][11][12][13].…”

Section: Discussionsupporting

confidence: 94%

Long-Term Evaluation of Donor-Site Morbidity After Radial Forearm Flap Phalloplasty for Transsexual Men

Caenegem

Verhaeghe

Taes

et al. 2013

The Journal of Sexual Medicine

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Introduction Phalloplasty using the radial forearm flap is currently the most frequently used technique to create the neophallus in transsexual men (formerly described as female-to-male transsexual persons). Although it is considered the gold standard, its main disadvantage is the eventual donor-site morbidity in a young, healthy patient population. Aim The study aims to examine the long-term effects of radial forearm flap phalloplasty in transsexual men and to evaluate aesthetic outcome, scar acceptance, bone health, and daily functioning. Main Outcome Measures Scars were evaluated with the patient and observer scar assessment scale, the Vancouver Scar Scale, and self-reported satisfaction. Bone health was assessed using dual X-ray absorptiometry and peripheral quantitative computed tomography, and daily functioning using a physical activity questionnaire (Baecke). These measurements were compared with 44 age-matched control women. Methods This is a cross-sectional study of 44 transsexual, a median of 7 years after radial forearm flap phalloplasty, recruited from the Center for Sexology and Gender Problems at the Ghent University Hospital, Belgium. Results We observed no functional limitations on daily life activities, a pain-free and rather aesthetic scar, and unaffected bone health a median of 7 years after radial foreram flap phalloplasty. Over 75% of transsexual men were either satisfied or neutral with the appearance of the scar. Conclusions Transsexual men, despite scarring the forearm, consider the radial forearm flap phalloplasty as worthwhile.

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Section: Discussionsupporting

confidence: 94%

Long-Term Evaluation of Donor-Site Morbidity After Radial Forearm Flap Phalloplasty for Transsexual Men

Caenegem

Verhaeghe

Taes

et al. 2013

The Journal of Sexual Medicine

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“…and sympathetic nerve damage. 13,14 In the studies conducted to analyze donor site morbidity of the radial flap, the prevalence of such symptoms varies greatly (from 0 to 38%), [3][4][5]7,[15][16][17] and in no publication has an association between these symptoms and any kind of vascular impairment to the hand demonstrated. In fact, retrospective studies comparing the donor hand to the contralateral "healthy" hand using Doppler ultrasonographic evaluation and thermography techniques 15,18,19 failed to verify any vascular morbidity, as did the only published prospective study we have been able to find to date concerning donor site complications.…”

Section: Discussionmentioning

confidence: 99%

“…However, donor site complications [3][4][5] and the inherent vascular morbidity involved in sacrificing the radial artery have been strongly criticized, and subsequently other free flap descriptions, along with new reverse flow forearm flaps, have removed some surgical indications for use of the radial forearm flap, despite several modifications published for minimizing the donor site morbidity. [6][7][8] Despite the fact that only one report has been published of acute ischemia resulting from elevation of a radial flap, 9 harvesting of a forearm flap based on the radial artery has been thought to cause vascular morbidity to the donor upper extremity, since one of the major sources of blood supply to the hand is eliminated.…”

mentioning

confidence: 99%

Flow changes in forearm arteries after elevating the radial forearm flap: prospective study using color duplex imaging.

Talegón-Meléndez

Ciria-Lloréns²,

Gómez-Cía³

et al. 1999

Journal of Ultrasound in Medicine

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n reconstructive surgery, microvascular free tissue transfers have gradually evolved from being a procedure of last resort to becoming a first choice operation in the last two decades. For this reason, careful preoperative assessment of the vascular anatomy of both donor tissue pedicles and recipient vessels is mandatory when planning these reconstructive procedures, and CDI has proved to be very useful for this purpose. Many other CDI applications in reconstructive microsurgery have been introduced recently, 1 and its contribution in assessing the vascular morbidity of the radial forearm flap is presented in this paper. Use of the radial forearm flap, a fasciocutaneous flap supplied by the radial artery, is a versatile and reliable technique for different reconstructive problems. The aim of the present study is to assess the changes in flow patterns of forearm arteries caused by excision of the radial artery when harvesting the radial forearm flap to clarify the vascular morbidity. To this purpose, a prospective study was designed using CDI for preoperative and postoperative quantitative flow measurements in forearm arteries. The aim of the present study was to assess the changes in flow patterns of forearm arteries produced by excision of the radial artery when harvesting the radial forearm flap. A prospective study using color duplex imaging for quantitative flow measurements was accomplished in 11 patients. After raising the radial flap, the forearm flow tended to increase overall, the ulnar (P = 0.04), the posterior interosseous (P = 0.003), and the anterior interosseous (P = 0.003) arteries being responsible for this tendency. Therefore, harvesting of a radial flap must not be considered as causing vascular morbidity in terms of blood supply to the hand. KEY

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“…1 At one time, during the 1980s and early 1990s, the radial forearm osteocutaneous free flap (RFOFF) was also considered a good option for oromandibular reconstruction. [2][3][4][5] The RFOFF then fell out of favor until quite recently. Some of the most commonly cited reasons for its "demise were associated with donor site morbidity (fracture of the radius) and inadequate bone stock (bone length and quality).…”

Section: Introductionmentioning

confidence: 99%

Radial Forearm Osteocutaneous Free Flap in Maxillofacial and Oromandibular Reconstructions

et al. 2005

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Reducing Morbidity in the Radial Forearm Flap Donor Site

Cited by 79 publications

References 0 publications

Long-Term Evaluation of Donor-Site Morbidity After Radial Forearm Flap Phalloplasty for Transsexual Men

Long-Term Evaluation of Donor-Site Morbidity After Radial Forearm Flap Phalloplasty for Transsexual Men

Flow changes in forearm arteries after elevating the radial forearm flap: prospective study using color duplex imaging.

Radial Forearm Osteocutaneous Free Flap in Maxillofacial and Oromandibular Reconstructions

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