Versatility of Radial Forearm Free Flap in Reconstruction of different Defects: A Cross-sectional Study

Abstract

Introduction: The Radial Forearm Free Flap (RFFF) is a commonly used flap for soft tissue reconstruction, offering several advantages despite sacrificing the radial artery in the forearm. Understanding the anatomy of radial artery perforators, including their distribution, territory, and flow is crucial for reliable and safe flap harvest and design. Aim: To describe the versatility and applications of RFFF in reconstructing defects in various body parts. Materials and Methods: This cross-sectional study was conducted in the Department of Plastic and Reconstructive Surgery at SCB Medical College and Hospital, Cuttack, between January 2019 and January 2021, on 39 cases (age group: 20-70 years) who underwent RFFF. RFFF was utilised for reconstruction of the lip, palate, buccal mucosa, tongue, foot, nose, and phallus. Preoperative evaluation included assessing the vascular status of the non dominant hand using the Allen’s test. Results: RFFF was used for postcancer resection reconstruction in 11 cases of buccal mucosa (28.2%), 7 cases of the lip (17.9%), 6 cases of the tongue (15.3%), 2 cases of the palate (5.1%), 2 cases of phallus reconstruction (5.1%), 1 case of post-traumatic nose defect, and 1 case of 1st web space of the hand (2.5%). In 26 cases of postcarcinoma resection reconstruction, RFFF was used for buccal mucosa, lip, tongue, and palate. The patients were followed up for 2-8 months. Conclusion: RFFF fulfills most of the anatomical prerequisites for an ideal flap, providing a microvascular reconstructive option for patients with large defects in the head and neck, foot and ankle, and phallus. It exhibits a high success rate, good aesthetic and functional outcomes, allowing for the reconstruction of various defects. This study confirms the reliability of the radial free flap as a method for reconstructive surgery.