[Rotation and advancement of the radial-based fasciocutaneous flap for primary closure of the radial forearm flap donor defect].
OBJECTIVE
This study aims to investigate the feasibility and clinical application value of a new method for primary donor-site closure of radial forearm flaps with the use of rotation and advancement of radial-based fasciocutaneous flaps.


METHODS
The forearm donor-site defects of 36 patients were primarily closed by rotation and advancement of radial-based fasciocutaneous flaps after radial flap harvest from November 2014 to May 2015. Patients included 28 males and 8 females aged 28 to 67 years (53.6 years old on average). Flap size ranged from 3.0 cm×5.0 cm to 4.0 cm×6.0 cm. Wound healing, scar hyperplasia, and forearm appearance were recorded and evaluated. Wrist flexion angle, dorsal extension angle, ulnar deviation angle, and radial deviation angle were measured three and six months after the operation. Wrist joint loss index was calculated and compared with the preoperative index to evaluate wrist function recovery. The results were subjected to comparative t- test to perform statistical analysis with SPSS 19.0 statistical software package.


RESULTS
Forearm donor sites were successfully closed without skin grafting in all patients. Skin ischemia caused by excessive tension was observed at the incision edge in five cases, thereby leading to skin exfoliation and pigment loss without affecting wound healing. All patients were followed up at six and twelve months, and presented a satisfactory appearance. No scar hyperplasia was observed. No significant difference was observed in radial deviation, ulnar deviation, palmar flexion, dorsiflexion, radial deflection angle, or wrist joint loss index (P>0.05) after the operation.


CONCLUSIONS
Application of rotation and advancement of radial-based fasciocutaneous flaps can directly close small-to-medium radial forearm flap donor defects. Satisfactory postoperative appearance can be achieved with no loss in wrist joint function. The novel method prove worthy of promotion and application in clinical work.
Dept. of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha 410008, China.
Gao
G
Zhengyang
Dept. of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha 410008, China.
Jiang
J
Canhua
Dept. of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha 410008, China.
Chen
C
Jie
Dept. of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha 410008, China.
Wu
W
Limeng
Dept. of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha 410008, China.
Ren
R
Hui
Dept. of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha 410008, China.
Long
L
Fuqiang
Dept. of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha 410008, China.
He
H
Chunrui
Dept. of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha 410008, China.
Jian
J
Xinchun
D000328:Adult; D000368:Aged; D005260:Female; D005542:Forearm; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D012399:Rotation; D012867:Skin; D016038:Skin Transplantation; D013524:Surgical Flaps; D014945:Wound Healing; D014953:Wrist
radial forearm flap; radial-based fasciocutaneous flap; rotation and advancement; wrist joint loss index