Innovative use of radial artery retrograde forearm flap for oral and maxillofacial reconstruction
Year: 2024
Type: article
Abstract: • An original technique for harvesting forearm flaps is put forward, entitled “radial artery retrograde forearm flap” (RARPFF). • Flap harvesting is a relatively straightforward and minimally invasive procedure. • The donor area of the new forearm flap allows for direct closure, in contrast to the traditional method. • The new forearm flap gives access to more tissue. • Avoiding any adverse effects on hand and wrist function. The purpose of this study is to present a novel method of reconstructing oral and maxillofacial defects using the Radial Artery Retrograde Proximal Forearm Flap (RARPFF) and to evaluate the efficacy and safety of the forearm flap for direct closure of the donor site and its effect on hand function in the donor area. A prospective study of 30 patients who underwent oral and maxillofacial reconstruction with RARPFF between June 2021 and April 2024 was conducted to evaluate the safety and efficacy of the flap and its influence on hand function in the donor area. Flap survival was 93.3 %. The donor site defect in 28 out of 30 patients healed primarily. All donor sites were directly closed without complications such as splitting, tendon exposure, or numbness in the thumb or thenar region. Statistically significant differences were observed in grip strength (MD = 4.56, p < 0.001) and elbow extension (MD = 2.78, p < 0.001) at 3 months, as well as in grip strength (MD = 2.20, p < 0.001) and elbow extension (MD = 1.67, p < 0.001) at 1 year, compared to the contralateral hand. Wrist flexion, extension, radial deviation, ulnar deviation, elbow flexion, pronation, and supination did not exhibit statistically significant differences from the contralateral hand at both 3 months and 1 year. The Michigan Hand Questionnaire (MHQ) revealed a statistically significant difference in aesthetics compared to the contralateral hand (p < 0.001), along with satisfactory overall hand function, activities of daily living (ADL), work performance, pain levels, and patient satisfaction with hand function. The reverse radial artery proximal forearm flap is a dependable and secure technique for head and neck reconstruction. This method can effectively reduce donor site complications while preserving hand function.
Source: Oral Oncology
Authors: Hui Peng, Li Y. Zhang, Wei Z. Zhu, Yu Zhou
Institution: University of Science and Technology of China
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,510
OpenAlex ID: W4404108994