Prelamination of Radial Forearm Free Flap with Buccal Mucosa

Abstract

Reconstruction of extripative defects in the head and neck with vascularized free tissue transfer has become the standard of care. In order to overcome disadvantages of the traditional radial forearm free flap (RFFF), e.g., color and texture difference, bulk, and donor site morbidity, the concept of prelamination of the RFFF with mucosa was developed. The term prelamination, introduced in 1994, is a process in which tissue is implanted into a vascular flap prior to transfer [1]. Prelamination with oral mucosa has been implemented in the reconstruction of a variety of intraoral and facial defects [2–4]. With their high cell renewal rate, morcelized buccal mucosal grafts can spread over a vascularized fascial bed and become functional in 3 weeks [2]. The resultant mucosa resembles the native oral mucosa both macroscopically and histologically [5], providing lubrication. Fasicomucosal flaps are thinner than fasciocutanous flaps since no subcutaneous tissue is included. This allows for better tongue mobility and rehabilitation [2]. We studied patients who underwent reconstruction with a prelaminated radial forearm fasciomucosal flap (RFFMF) to describe surgical technique and report multi-institutional outcomes.