Clinical applications of superficial radial nerve nutrient vessel flaps in the forearm

Abstract

Objective To summarize the clinical results of retrograde transfer of forearm superficial radial nerve nutrient vessel flaps to repair skin and soft tissue defects in the hand. Methods From June 1999to December 2010,forearm superficial radial nerve nutrient vessel flaps were retrogradely transferred to cover soft tissue defects of the hand in 15 cases.The projection of the course of superficial radial nerve in the forearm was used as the axis of the flap.The flap was designed along the axis and dissected sharply beneaththe deep fascia.It was then rotated distally to reach the defects in the hand.If a sensate flap was needed,the cutaneous nerve included in the flap was coapted to the cutaneous nerve of the recipient site. Results Of the 15 flaps,2suffered from subcutaneous blood stasis in the distal 1/3 of the flap.Skin necrosis of 1.5 cm× 1.0 cm at the tip of the flap was debrided and healed after dressing changing in one case.The rest of the flaps survived uneventfully.The appearance and function of the flaps were satisfactory through 4 months to 8 years of follow-up.Conclusion This flap is easy to harvest,causes minor donor site morbidity,offers flexible transfer options and can be transferred as a sensate flap.It has good appearance with matching skin color of the recipient site.It is an ideal method in the repair of soft tissue defects of the palm,dorsum of the hand and the first web space. Key words: Surgical flaps; Radial nerve; Superficial branch