The radial forearm snake flap: An underutilized technique for fasciocutaneous and osteocutaneous forearm flaps with primary closure

Abstract

Background The radial forearm free flap (RFFF) is associated with troublesome donor site morbidity related to split thickness skin grafting (STSG). The radial forearm snake flap with primary closure of the donor site may reduce donor site complications. Methods Single institution, retrospective cohort study comparing rates of delayed donor site wound healing and tendon exposure in 52 patients undergoing radial forearm snake flap and 95 patients undergoing conventional RFFF with STSG closure of the donor site. Results Tendon exposure occurred in zero (0%) patients undergoing snake flap and four (4.2%) patients undergoing conventional RFFF (0/52 vs. 4/95; p = 0.297). Delayed wound healing occurred in zero (0%) patients undergoing snake flap and 19 (20.0%) patients undergoing conventional RFFF (0/52 vs. 19/95; p < 0.001). Conclusions The radial forearm snake flap provides an alternative to conventional RFFF harvest, which enables primary donor site closure with reduced rates of delayed donor site healing.

Substantial reconstruction of segment of index by osteo-tendocutaneous pedicled radial forearm flap: Case report

“…Tissue expansion, negative pressure wound therapy, and advancement and narrow flaps were used to close the donor site primarily instead of resurfacing of defect by skin graft. Disadvantages of split-thickness skin grafts such as; graft loss, exposed tendons, long-term unpleasant appearance and hypertrophic scar can occurre, but the skin graft is still commonly used for donor site closure [17]. In our patient, the skin graft healed uneventfully same as the skin graft donor site, while the appearance was accepted by the patient with mild hyperpigmentation compared to the adjacent local skin.…”