Anatomical basis and clinical application of the ulnar forearm free flap for head and neck reconstruction.
OBJECTIVE
This study was designed to investigate the anatomical features and applications of the ulnar forearm flap in head and neck reconstructive surgery.


METHODS
A prospective study was designed to include 50 ulnar forearm free flap transplants in 50 patients. Patient defects requiring reconstructive surgery involved the buccal mucosa, tongue, floor of the mouth, upper or lower gums, lips, soft palate, and scalp. Twenty ulnar forearm flaps were analyzed along the entire ulnar artery to determine the anatomy and distribution of the ulnar artery septocutaneous perforators.


RESULTS
All 50 flaps were successfully transplanted into their respective sites. The mean diameters of the ulnar artery and vein were 2.3 ± 0.6 mm and 1.7 ± 0.6 mm, respectively. Arterial and venous size mismatch was experienced in 12 and 33 flaps, respectively. The mean number of sizable perforators was 4.3 ± 1.2, and most of the first perforators were located within 5 cm of the proximal wrist crease. None of the patients experienced long-term complications concerning the ulnar nerve.


CONCLUSIONS
The ulnar forearm flap is a reliably consistent source of free flap transfer because it harbors constant septocutaneous perforators and produces minimal donor site morbidities for head and neck reconstructive surgery.
Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College, Chang Gung University, Taipei, Taiwan.
Jung-Ju
JJ
Huang
Chih-Wei
CW
Wu
Wee Leon
WL
Lam
Dung H
DH
Nguyen
Huang-Kai
HK
Kao
Chia-Yu
CY
Lin
Ming-Huei
MH
Cheng
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005542:Forearm / Q000601:surgery*; D058752:Free Tissue Flaps / Q000098:blood supply*; D006085:Graft Survival; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D016038:Skin Transplantation / Q000379:methods*; D016896:Treatment Outcome; D017535:Ulnar Artery / Q000601:surgery*