The radial forearm snake flap: A novel approach to oral cavity and oropharyngeal reconstruction that reduces forearm donor site morbidity

Garg, Rajnish; Wieland, Aaron M.; Poore, Samuel O.; Sanchez, Ruston; Hartig, Gregory K.

doi:10.1002/micr.22425

Cited by 22 publications

(33 citation statements)

References 30 publications

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“…The harvested tissue can be tubed upon itself before insetting the flap into the neck. 13,14 Forearm free flap offers a thin, pliable, and versatile fasciocutaneous tissue with a long and reliable pedicle 1,3,4,7,9,14,15 (►Figs. 1, 2).…”

Section: Radial Forearm Free Flapmentioning

confidence: 99%

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Pharyngeal Reconstruction with Microvascular Free Tissue Transfer

Sokoya

Bahrami

Vincent

et al. 2019

Seminars in Plastic Surgery

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Reconstruction of pharyngoesophageal defects after total laryngectomies and extirpation of hypopharyngeal and upper esophageal carcinomas presents a challenging task. Goals of reconstruction include adequate voice rehabilitation and restoration of normal swallowing. The reconstructive armamentarium contains many options for reconstruction and creation of a new upper digestive tract. This review article focuses on the most commonly used free tissue transfer options for the reconstruction of these defects, with an assessment of their advantages and disadvantages.

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Section: Radial Forearm Free Flapmentioning

confidence: 99%

“…14 The main disadvantage of the forearm flaps is the need for split-thickness skin graft covering of the donor site leading to potentially poor functional and aesthetic outcomes. 9,14,15…”

Section: Radial Forearm Free Flapmentioning

confidence: 99%

Pharyngeal Reconstruction with Microvascular Free Tissue Transfer

Sokoya

Bahrami

Vincent

et al. 2019

Seminars in Plastic Surgery

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“…To date, many options are available for closing the RFFF donor site without the need for an additional operative site. These included ipsilateral FTSG, hinged radial forearm STSG, ulnar perforator flap, cross‐suturing, artificial skin graft, tissue expander, local hatchet flap, and snake design RFFF flap …”

Section: Introductionmentioning

confidence: 99%

“…It has many advantages as the ideal tissue replacement, such as a long vascular pedicle, constant, reliable anatomy, ease of harvest, thin pliable, supple skin, the possibility of reinnervation, two teams operating, and a high success rate (90%-100%). [2][3][4] Despite these advantages, the donor site defect remains the major disadvantage of the RFFF. Split-thickness skin grafting (STSG) and full-thickness skin grafting (FTSG) are the most common methods used for covering the donor site defect.…”

Section: Introductionmentioning

confidence: 99%

“…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. This to the authors' knowledge has not previously been described.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

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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.

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The radial forearm snake flap: A novel approach to oral cavity and oropharyngeal reconstruction that reduces forearm donor site morbidity

Cited by 22 publications

References 30 publications

Pharyngeal Reconstruction with Microvascular Free Tissue Transfer

Pharyngeal Reconstruction with Microvascular Free Tissue Transfer

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

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

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