Refinements in microvascular repair of extended oromaxillofacial defects with radial forearm free flap.
The radial forearm free flap (RFFF) is one of the most widely used and versatile fasciocutaneous free flaps in head and neck reconstruction because of its qualities--the consistent vascular anatomy; the thin and pliable nature; the minimal hair presence; and the possibility of harvesting and transferring it as a composite tissue flap, with bone, tendon, and nerve. The RFFF provides a method of single-stage reconstruction of wide residual defects after excision of advanced cancer (T3-T4) in the head and neck region. We present our ten-year experience with RFFF and the good results obtained with some refinements, which allowed us to verify the efficacy of the oral competence using the palmaris gracilis tendon as a sling. We also present the possibility of harvesting long segments of radius (up to 18 cm), and the discovery that use of antithrombotic or anticoagulant therapy is not necessary for the flap survival. This treatment does not guarantee a complete recovery, but it can improve the quality of the patient's life.
Rigotti
G
G
Second Department of Plastic Surgery, General Hospital, Verona, Italy.
Cristofoli
C
C
Gibelli
P L
PL
Marchi
A
A
Bruti
M
M
D000328:Adult; D000368:Aged; D005153:Facial Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D005260:Female; D005542:Forearm; D006085:Graft Survival; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply*; D015996:Survival Rate; D014945:Wound Healing