Radial Forearm Flap

Question 1

Advantages of radial forearm flap

Answer 1

Thin, pliable skin Highly tolerant of radiation

Question 2

Indications for tongue recon

Answer 2

1. >50% tongue resected 2. Anterior 2/3 tongue resected

Question 3

Which free flap is highly tolerant of radiation therapy

Answer 3

Radial forearm flap

Question 4

What length of radius can be harvested in osteocutaneous radial flap

Answer 4

10-12cm

Question 5

Flaps for tongue recon

Answer 5

Radial forearm Rectus abdominus Latissimus dorsi

Question 6

Reconstruction Ladder/Elevator

Answer 6

Simple –> Complex Free flap Regional flap Local flap Skin graft Primary closure Secondary healing

Question 7

List Aorta to palmar arches

Answer 7

Question 8

Physical exam pearls preop assessment

Answer 8

Examine feet for signs of PVD

Palbable posterior/anterior tibial pulses

Modified allen’s (eval palbable pulse of anterior when compressing posterior, vice versa)

Question 9

Pedicle - Radial forearm flap

Answer 9

+ Radial a. + Venae comitantes +/- cephalic vein + Lateral antebrachial cutaneous nerve + Pedicle length = 20cm + Vessel caliber = 2-2.5mm

Question 10

Preop planning factors with free flaps

Answer 10

1. Amount and type of tissue at defect 2. PSH or injury at donor site 3. Donor morbidity 4. Patient positioning and donor location 5. Need for carotid coverage 6. General Med status 7. Hypercoag work-up

Question 11

What does Allen test evaluate

Answer 11

Palmar arch (Deep and superficial) - Negative (normal) = complete palmar arch - Positve = incomplete palmar arch

Question 12

Classify radial forearm flap

Answer 12

Fasciocutaneous flap (Can be osteocutaneous flap) Free flap

Question 13

Skin paddle dimensions radial forearm flap

Answer 13

Up to 3/4 ventral forearm skin