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The radial forearm free flap is an incredibly versatile option for head and neck reconstruction and is an excellent option when performed at the hands of an experienced microvascular surgeon.
The radial forearm flap is supplied by the radial artery and perforators from the radial artery to the overlying skin. The venae commitans of the radial artery or the cephalic vein can be used for venous drainage.
The radial free forearm flap (RFFF) was one of the first free tissue transfer flaps to be described. It has since become a workhorse for soft tissue replacement in head and neck cancer surgery, being commonly used to replace external skin and internal mucosal linings.
The forearm flap is a fasciocutaneous flap based on the fasciocutaneous perforators from the radial artery. The number of perforators is greatest between 12 and 20 cm from the takeoff of the radial artery, and these are the vessels captured in the distally located skin paddle.
The osteocutaneous radial forearm flap is a variant of the fasciocutaneous radial forearm free flap, in which partial thickness of the radius is harvested and perfused by preserving the lateral intermuscular septum and the perforating vessels to the bone.
Similar to widespread use of the pectoralis major pedicled myocutaneous flap for intraoral reconstruction in the 1980s and early 1990s, the radial forearm free flap has become the workhorse flap for intraoral reconstruction in the late 1990s and early 2000s. This flap is based on the radial artery.
The radial free forearm flap (RFFF) was one of the first free tissue transfer flaps to be described. It has since become a work-horse for soft tissue replacement in head and neck cancer surgery, being commonly used to replace external skin and internal mucosal linings.
The radial forearm flap (RFF) is one of the first flaps utilized in reconstruction of soft tissue defects. It can be used either as a pedicled flap with the pivot point either distal, at the wrist, or proximal at the antecubital fossa, or as a free flap.
The radial forearm free flap, highly regarded in head and neck reconstructive surgery, is known to be one of the most reliable and versatile flaps. The microsurgery is usually easy to perform due to large vessels and a long pedicle; the double superficial and deep venous networks allow many microsurgical options.
The osteocutaneous radial forearm free flap (OCRFFF) is a versatile flap with the ability to reconstruct complex defects. We detail the techniques necessary to harvest an OCRFFF, including an outline on making 90-degree osteotomies to maximize bone harvest.