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Krishnakumar Thankappan Nirav P. Trivedi Mohit Sharma Moni A. Kuriakose Subramania Iyer 《Indian Journal of Plastic Surgery》2009,42(1):100-103
A free radial forearm fascial flap has been described for intraoral reconstruction. Adiposo-fascial flap harvesting involves few technical modifications from the conventional radial forearm fascio-cutaneous free flap harvesting. We report a case of inferior maxillectomy defect reconstruction in a 42-year-old male with a free radial forearm adiposo-fascial flap with good aesthetic and functional outcome with minimal primary and donor site morbidity. The technique of raising the flap and closing the donor site needs to be meticulous in order to achieve good cosmetic and functional outcome. 相似文献
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Treatment of midface gunshot injuries and their reconstruction remains one of the difficult problems of reconstructive surgery. Several flaps have been described for the reconstruction of total lip and nasal defects. We present a case of a gunshot wound to the midface in which a two-stage procedure was performed. In the first stage, a free radial forearm flap was successfully transferred for the reconstruction of the total nose. In the second stage, total upper lip reconstruction was achieved using a parietal osteofasciocutaneous flap pedicled to the parieto-temporal fascia based on the superficialis temporal artery. At a mean follow-up period of 18 months, near-normal functional and cosmetic results were obtained. 相似文献
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Summary Eighteen patients with intraoral and oropharyngeal carcinoma were treated by radical excision for extensive infiltration of tumour into adjacent tissue. Defects were repaired by free radial forearm flaps. Three patients had bony defects in addition to mucosal and skin defects. The free flap can be easily folded to repair skin and mucosa simultaneously. We consider the free forearm flap to be the procedure of choice in selected cases of large intraoral and adjacent cheek defects. 相似文献
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Described in 1981 by the Chinese authors Yang Kuofan et al. [1] as a free flap, then in 1982 by Lu et al. [2] as a retrograde
flow pedicle flap, this fasciocutaneous flap is designed at the level of the anterior and external faces of the forearm, and
vascularized by the radial artery via a network of septal arteries. Prior to utilization it must be reversed on its distal
pedicle. This flap allows repairing cutaneous substance loss of the whole hand and fingers. The emergence of the Chinese flap
in the 1980’s resulted in a regression of the Mac Gregor groin flap that was widely used at this time [3,4]. Nevertheless,
other forearm flaps, less “expensive” in terms of vascular involvement [5–9] have reduced its indications. The Chinese flap
however keeps two essential indications: the multi-finger important defect that no other forearmflapmay cover; and composite
substance loss of the thumb (despite the fact that the Chinese flap shares these indications with interosseous artery composite
flaps). 相似文献
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Summary Treatment of cancer of the cervical aerodigestive tract is challenging due in part to the difficulty in reestablishment of pharyngoesophageal continuity after resection of the involved tract. From May 1989 to August 1990, six patients underwent immediate reconstruction utilizing microvascular transfer of free radial forearm flaps following resection of pharyngoesophageal neoplasms. A small island flap connected to the radial vascular pedicle by fasciocutaneous branch was used to monitor the vascular condition of the hidden fabricated free forearm flap. Stricture is the most troublesome complication of esophageal reconstruction using a conventional free forearm flap. Two small triangular flaps were designed and inserted bilaterally in the distal anastomosis of both lateral esophageal walls to prevent circular contracture. The outer layer sutures were anchored to surrounding rigid structures to withstand shrinkage and circular contraction. The problem of stricture was solved by these procedures. This one-stage, easily monitored operation for pharyngoesophageal reconstruction is considered to be as useful as a free jejunal transfer. 相似文献
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TORU KANNO NOBORU SHIBASAKI MASAAKI ITO YUTAKA TSUJI YOJI TAKI HIDEO TAKEUCHI HIROYA MIHARA MIKA IKEDA YUJI YOSHIMOTO 《International journal of urology》2005,12(2):228-230
Abstract A 47-year-old man was admitted with the chief complaint of a urethral defect. An approximately 17-cm defect of the urethra seemed to have been occurred by the infection of implanted foreign bodies in the penile skin. Reconstruction of the urethra and the ventral skin was performed with a free radial forearm flap. A fistula formed at the proximal anastomosis after the operation, but was controlled conservatively. Urethral stricture at the proximal anastomosis subsequently developed. A urethral stent made of shape memory alloy was placed with the preservation of voiding function. 相似文献
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Dale A Classen 《CANADIAN JOURNAL OF PLASTIC SURGERY》2005,13(2):77-81
Alternative techniques for pedicle transfer of a reverse radial forearm flap for hand coverage, and a latissimus dorsi myocutaneous free flap for pelvic wound coverage, are illustrated. Exteriorization of the vascular pedicle of a reverse radial forearm flap allows a greater arc of movement of the flap for more distal coverage, and avoids the potential vascular compromise of tunnelling under a tight skin bridge. Two-stage transfer of a latissimus dorsi myocutaneous free flap on a wrist carrier pedicle may be useful in circumstances when local recipient vessels are inadequate for free flap transfer. Although both of these vascular pedicle modifications have drawbacks, they may be of value in limited circumstances. Their advantages and limitations are discussed. 相似文献
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Within a 2-year period ten patients aged 5–22 years were treated for facial sequelae of noma. In six cases free radial forearm
flaps were used, combined with local and regional flaps. The indications were defects located in the midface and perioral
area. There were no free or regional flap losses in this series. The aesthetic and functional results were appreciated by
the patients and there were no functional problems related to the donor area because a suprafascial flap dissection technique
was used. In our experience the free radial forearm flap is a valuable option for facial reconstruction in NOMA cases. The
advantages include: (1) A very long and large calibre pedicle; (2) thin and pliable flaps of variable size and configuration;
(3) the possibility of single stage reconstruction in selected cases. The disadvantages include the not always ideal colour
match, both in black patients and in white, and the unsightly donor area which, however, has never led to functional problems.
Received: 25 May 1999 / Accepted: 6 June 1999 相似文献
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Noaman HH 《The Journal of hand surgery》2012,37(4):832-836
Complete ring avulsion injury necessitates a difficult choice between microvascular repair and revision amputation. Microvascular repair is technically difficult and amputation may leave an unsatisfactory result. We describe an alternative method whereby a reverse radial forearm flap is wrapped around the complete degloved digit. This provides good quality cover to the whole volar, dorsum, and both sides of the finger. We performed 26 pedicle radial forearm flaps for 26 patients in the Hand and Reconstructive Microsurgery Unit, Sohag University Hospital, from 2001 to 2009. Indications included soft tissue coverage of the thumb (n = 8), ring finger (n = 11), index finger (n = 4), middle finger (n = 2), and little finger (n = 1). Finger salvage was successful in 96% of patients. There was complete loss of 1 flap and partial flap loss of a second. Finger range of motion was excellent in 18 fingers, good in 7, and fair in 1. Two donor sites were closed primarily; the rest were closed with split-thickness skin grafts. There were no reports of cold intolerance of the hand or dysesthesias in the superficial radial nerve or lateral antebrachial nerve distribution. 相似文献
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PURPOSE: To report the outcome of the modified design of the osseofasciocutaneous radial forearm flap. The flap was modified because of problems associated with the use in thumb reconstruction. METHODS: We performed retrospective review of all patients who sustained nonreplantable thumb amputations who had this procedure between August 2000 and March 2005. The patients' ages ranged between 24 and 39 years. Demographic data and details of the level of amputation and alternative surgical procedures were reviewed. Eight male patients were identified and constituted the study cohort. The size of flap, length of the radius harvested, time to union, sensibility (moving 2-point discrimination test), grip and pinch strengths, complications, and patient outcome were determined. RESULTS: All patients who had the butterfly design of the reverse-flow osseofasciocutaneous radial forearm flap had an adequate and painless soft-tissue padding on the tip of the reconstructed thumb that provided good protection for the distal stump of the vascularized bone graft. Patients did not experience strictures at the bottom of the reconstructed tubes. CONCLUSIONS: The butterfly design is a useful modification of the skin paddle of the reverse osseofasciocutaneous radial forearm flap for thumb reconstruction. The design offers an easy way to reconstruct a tube shape with adequate padding on the tip and no terminal scar. In addition it prevents the constricting effect of the circumferential scar on the button of the reconstructed tube. 相似文献
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Resurfacing of the nasopharynx after nasopharyngectomy using a free radial forearm flap 总被引:1,自引:0,他引:1
BACKGROUND: Nasopharyngectomy is emerging as an important treatment option for salvaging locally recurrent nasopharyngeal carcinoma (NPC). After nasopharyngectomy, resurfacing the nasopharynx and covering the internal carotid artery is important to minimize the risk of infection, osteoradionecrosis, and carotid rupture. Previous authors have advocated the use of free grafts of skin and mucosa for this purpose but have also described significant rates of partial and total graft failure. METHODS: We believe that the best and most reliable way to resurface the nasopharynx is with vascularized tissue, and our preference is for the use of a free radial forearm flap. To illustrate our approach, we present two patients who underwent nasopharyngectomy by means of a maxillary swing approach and who had resurfacing of the surgical defect with a free radial forearm flap. RESULTS: Both patients had complete en bloc resection of tumor followed by the insetting of a free radial forearm flap to reline the surgical defect. Both flaps remained completely viable, and both patients achieved successful resurfacing of the entire nasopharynx. The morbidity of surgery was minimal, and there were no perioperative complications. On assessment 1 year later, the free radial forearm flap continues to reline the entire neonasopharynx, and the long-term functional recovery after surgery is excellent. CONCLUSION: Resurfacing the nasopharynx after nasopharyngectomy with a free radial forearm flap aids healing and minimizes the risk of complications. The morbidity of surgery is minimal and the functional recovery is excellent. 相似文献
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目的 探讨颞肌蒂下颌骨瓣与游离前臂皮瓣联合修复腭上颌缺损的临床疗效. 方法 2008年3月至2011年3月,共收治恶性肿瘤切除后腭上颌缺损9例,其中男6例,女3例,年龄34~68岁,平均57岁.根据Browm上颌骨缺损分类,其中Ⅱ B类8例,Ⅱ C类1例.均采用颞肌蒂下颌骨瓣与游离前臂皮瓣联合修复. 结果 9例移植的骨瓣及皮瓣均成活.随访期10~24个月,平均随访期14个月,除1例软骨肉瘤病例术后复发外,其余病例的面部外形和功能均恢复满意,供区未见并发症.结论 应用颞肌蒂下颌骨瓣与游离前臂皮瓣联合修复腭上颌缺损具有操作简单易行、安全可靠和并发症少等优点,是修复上颌骨缺损的较理想术式. 相似文献
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《Journal of plastic surgery and hand surgery》2013,47(5):374-376
AbstractWe present the case of a 67-year-old woman with scleroderma who had progressive necrosis of the finger together with severe pain 20 years after harvesting of a radial forearm flap. After reconstruction of the radial artery the ulceration of her right middle finger healed spontaneously within a month, and the pain disappeared. 相似文献