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.

A radial forearm free flap is one way of filling a hole which is left when a cancer has been removed. It is one of the most common ways of replacing tissue in the head and neck, particularly after mouth cancers have been removed.

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.

Listen to pronunciation. (PEH-dih-kul …) A type of surgery used to rebuild the shape of the breast after a mastectomy. Tissue, including skin, fat, and muscle, is moved from one area of the body, such as the back or abdomen, to the chest to form a new breast mound.

Ruyao Song and his colleagues (1982) described the use of 3 1 forearm flaps to deal subsequently Stock et al. (1981) reported the use of the forearm skin as a neurovascular island flap to replace soft tissue defects of the hand.

The anterolateral thigh (ALT) flap (Fig. 22-4) is a very popular flap for lower limb reconstruction for several reasons. It is based on an area of skin and fascia on the anterolateral aspect of the thigh supplied by perforators of the descending branch of the lateral circumflex femoral artery.

The nasolabial flap is a simple flap used for reconstructing small intraoral defects created after the excision of malignant tumors.

Myocutaneous flaps are compound flaps with a solitary vascular supply incorporating skin, subcutaneous tissue, fascia, and the underlying muscle. Once a pedicled or free-tissue transfer is performed, the newly transferred flap begins to incorporate into the surrounding tissue.

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.

As defined by Hallock (Plast Recon Surg 117:151e, 2006), a chimeric flap “consists of multiple otherwise independent flaps that each have an independent vascular supply, with all pedicles linked to a common source vessel”.

The pectoralis major flap comprises the pectoralis major muscle, with or without overlying skin, and may include the under- lying ribs. It has an axial blood supply and is based superiorly on the pectoral branch of the thoracoacromial artery. Rib may be included to bridge mandibular defects.

This is a sensate axial musculomucocutaneous flap based upon the superior and inferior labial arteries. It provides good oral competence and is useful for closing one-half to two-third defects of the upper lip and defects up to three-quarters of the lower lip.

Although nearly all of the forearm skin can be taken as a free flap based on the radial artery angiosome, this would be highly morbid because of the disruption of the lymphatic drainage from the hand.

Surgical anatomy of volar forearm. The skin of the volar (anterior) surface of the forearm is usually thin and pliable, especially the distal half. It is however unfortunately hair-bearing skin, especially sides of the forearm; consequently, one might have hair growth e.g. in the oral cavity.

Elevate the flap from ulnar to radial side toward the flexor carpi radialis in the plane just above the muscular fascia. Take care to leave paratenons intact on tendons. Do not incise proximal margin of flap. Elevate flap from radial to ulnar side to the brachioradialis tendon.

Pertinent Anatomy 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.