• 대한두경부종양학회지
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• 제31권1호
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• pp.5-8
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• 2015

Backgrounds: The purpose of this study was to compare full thickness skin graft with inguinal skin to split thickness skin graft for coverage of the radial forearm free flap donor site. Patients and Methods: 25 patients who was reconstructed with radial forearm free flap for head and neck cancer were reviewed retrospectively. Results: The graft loss rates of full thickness skin graft were less than split thickness skin graft or split thickness skin graft with dermal substitutes. The recovery times of donor site and skin graft donor site of full thickness skin graft were also shorter than split thickness skin graft or split thickness skin graft with dermal substitutes. Skin texture and aesthetic results of donor site were improved and complications as itching and pain sensation were decreased. Conclusion: Full thickness skin grafts with inguinal skin should be considered for patients requiring a radial forearm free flap.

• Archives of Reconstructive Microsurgery
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• 제20권1호
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• pp.8-13
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• 2011

Purpose: A palatal defect following maxillectomy can cause multiple problems like the rhinolalia, leakage of foods into the nasal cavity, and hypernasality. Use of a prosthetic is the preferred method for obturating a palate defect, but for rehabilitating palatal function, prosthetics have many shortcomings. In a small defect, local flap is a useful method, however, the size of flap which can be elevated is limited. In 12 cases of palatomaxillary defect, we used various microvascular free flaps in reconstructing the palate and obtained good functional results. Method: Between 1990 and 2004, 12 patients underwent free flap operation after head and neck cancer ablation, and were reviewed retrospectively. Among the 12 free flaps, 6 were latissimus dorsi myocutaneous flaps, 3 rectus abdominis myocutaneous flaps, and 3 radial forearm flaps. Result: All microvascular flap surgery was successful. Mean follow up time was 8 months and after the follow up time all patients reported satisfactory speech and swallowing. Wound dehiscence was observed in 4 cases, ptosis was in 1 case and fistula was in 1 case, however, rhinolalia, leakage of food, or swallowing difficultly was not reported in the 12 cases. Conclusion: We used various microvascular flaps for palatomaxillary reconstruction. For 3-dimensional flap needs, we used the latissimus dorsi myocutaneous flap to obtain enough volume for filling the defect. Two-dimensional flaps were designed with latissimus dorsi myocutaneous flap, rectus abdominis flap and radial forearm flap. For cases with palatal defect only, we used the radial forearm flap. In palatomaxillary reconstruction, we can choose various free flap techniques according to the number of skin paddles and flap volume needed.

• Archives of Reconstructive Microsurgery
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• 제11권2호
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• pp.146-152
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• 2002

As the defects of the penis caused by trauma, surgical amputation, or congenital abnormality give the patients both psychological trauma and functional impairment, reconstruction of the penis is mandatory. Radial forearm free flap is reliable one-stage procedure, which can reconstruct both the phallus and the urethra. Chang and Whang's adaptation of the "tube-in-a-tube" concept and its incorporation into a free flap design represented a major advance in microsurgical phallic construction. Biemer described a modification of the radial forearm flap design in which the neourethra was centered over the radial artery, but the phallic shaft was separated into two paraurethral swatches. The authors have performed one-stage penile reconstruction in two patients since 1998, using a radial forearm free flap. Our present design incorporates the original Biemer triple skin island and includes a fourth distal island for neoglans. One case was the amputation of the penis from felonious assault and the other case was the iatrogenic penile amputation from repetitive urologic surgery for congenital hypospadia. All patients showed aesthetically acceptable results and good tactile sensory recovery. Severe complications such as necrosis, fistula, or urethral stricture were not occurred. Biemer's method modified by the authors is reliable one-stage penile reconstruction providing good aesthetic and functional results.

• 대한두개안면성형외과학회지
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• 제24권1호
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• pp.28-31
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• 2023

The radial forearm free flap (RFFF) has become popular for head and neck reconstructions. Owing to a constant anatomy the RFFF is relatively easy to dissect. Nevertheless, anatomical variations of the radial artery have been reported. Some variations could affect the survival of the flap. This paper reports an unusual anomaly of the radial artery where the radial artery was not located between the brachioradialis (BR) and flexor carpi radialis. The radial artery was observed above the BR and on the radial side of the BR. The survival of the elevated flap was deemed questionable because it had only few perforators. So we decided to discard the flap and to elevate another free flap for the head and neck defect. The donor area on the forearm was covered using the original skin of the first flap as a full-thickness skin graft. This case highlights a means to deal with anomalies of the radial artery encountered during the elevation of RFFF and the checking process for variations of the radial artery before RFFF.

• Archives of Reconstructive Microsurgery
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• 제11권2호
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• pp.179-185
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• 2002

The wrist and forearm are a frequently damaged area in high tension electrical injury as an input or output of the current. Electrical burns affecting the wrist and forearm may produce full thickness necrosis of the skin and damage deep vital structures beneath the eschar, affecting the local tendons, nerves, even bones and joints which result in serious dysfunction of the hand. From January 1997 to December 2001, we had treated 20 patients with high tension electrical burn in the wrist and forearm using anterolateral thigh free flap. Average follow up period were 24 months and we get satisfactory results both in functional and aesthetic aspects. This flap is considered useful in one-stage reconstruction of wide and large soft tissue defect combined with arterial injuries.

• Archives of Plastic Surgery
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• 제45권6호
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• pp.495-503
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• 2018

With significant improvements in success rates for free flap reconstruction of the head and neck, attention has turned to donor site morbidity associated with osteocutaneous free flaps. In this review, we address the morbidity associated with harvest of the four most commonly used osteocutaneous flaps; the free fibula flap, the scapula flap, the iliac crest flap and the radial forearm flap. A comprehensive literature search was performed to identify articles relevant to donor site morbidity for these flaps. We assessed morbidity in terms of incidence of delayed healing, chronic pain, aesthetic outcomes, site specific complications and patient satisfaction/quality of life. Weighted means were calculated when sufficient studies were available for review. The radial forearm and free fibula flaps are associated with high rates of delayed healing of approximately 20% compared to the scapular (<10%) and iliac flaps (5%). The radial forearm flap has higher rates of chronic pain (16.7%) and dissatisfaction with scar appearance (33%). For the majority of these patients harvest of one of these four osteocutaneous does not limit daily function at long-term follow-up. The scapular osteocutaneous flap is associated with the lowest relative morbidity and should be strongly considered when the recipient defect allows. The radial forearm is associated with higher morbidity in terms of scarring, fractures, chronic pain and wrist function and should not be considered as first choice when other flap options are available.

• Archives of Reconstructive Microsurgery
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• 제12권2호
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• pp.119-124
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• 2003

Introduction : The purpose is a retrospective evaluation of the clinical results of the radial forearm flap transfer for foot reconstruction. Materials and methods : We evaluated 21 cases with medical records including etiology, wound dimension, presence of infection, associated fracture, ischemic time of free flap, complication of donor and recipient site. The final results were evaluated with our clinical score (walking, shoe-in, cosmetic). Results : Defects were located on the heel (12 cases), dorsum of foot (4 cases) and sole (5 cases). Mean wound dimension was $7.56{\times}6.0cm$, and mean ischemic time of free flap was 94.5minute. There were superficial skin necrosis (1 case), recurrent ulceration (2 cases) in recipient site, and no complication in donor site but complaint about cosmetic problem (3 cases). The clinical score showed excellent in 14 cases, good in 4 cases, fair in 1 case and poor in 2 cases. Conclusion : We consider the radial forearm flap could provid the stable and durable restoration of normal foot contour without debulking in the foot reconstruction and achieved normal ambulation and cosmetic satisfaction.

• 대한치과의사협회지
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• 제52권10호
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• pp.615-622
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• 2014

Oral cancer ablation surgery results in tissue defects with functional loss. Accompanying neck dissection results in facial nerve weakness and dysmorphic changes. To minimize the complications after oral cancer surgery, accurate dissection without damaging facial nerve and vital structures are mandatory. Marginal mandibular branch of facial nerve should be dissected or contained in the superficial layer of deep cervical fascia to minimized facial palsy after operation. Reconstruction after cancer ablations is routine procedures and free flap reconstruction is the most commonly used. Radial forearm free flap is the most versatile flap to reconstruct soft tissue defects and it is easy to design according to the defect size and shape. However, donor site scar and secondary skin graft from thigh result in unesthetic and cumbersome wounds. Double layered collagen graft in the donor site could reduce secondary donor site for skin graft. In conclusion, oral and maxillofacial surgeon should know the exact anatomy of the face and neck during neck dissection. Radial forearm free flap is most versatile flap for soft tissue reconstruction and double collagen graft can reduce postoperative scar and there is no need for secondary skin graft.

• 대한두경부종양학회지
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• 제17권2호
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• pp.198-204
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• 2001

Background and Objectives: As the laryngopharyngeal cancer is usually found at a advanced stage, it is difficult to get a wide surgical margin that preserves functional aspect and that is oncologically safe simultaneously. There were many operative technique to fulfill this principle, but none were satisfactory. Recently there were some reports about glottic and pharyngeal reconstruction using radial forearm free flap(RFFF) with palmaris longus tendon, which provided satisfactory oncologic and functional results. We attempted to perform this technique and to test usefulness at patients of laterally localized laryngopharyngeal tumor. Materials and Methods: Three patients were reconstructed glottis and pharynx using radial forearm free flap with palmaris longus tendon. Two hypopharyngeal cancer (T2N0M0) patients were performed wide vertical hemilaryngopharyngectomy and one supraglottic cancer(T2N0M0) patient was performed horizontovertical laryngopharyngectomy. Deglutitional function was evaluated with modified barium swallow and speech function was evaluated by speech pathologist. Results: Mean follow-up time was 29.3 months. There were no cancer recurrence. Their speech was satisfy-actory at social communication and oral feeding. They all have a complete oral nutrition from 26 days to 53 days. Decanulation time was from 71 days to 30 months. Conclusion: Glottic and pharyngeal reconstruction with radial forearm free flap could be accepted as a promising technique which offers a wide resection margin but satisfactory functional result in lateralized laryngohypopharyngeal cancer patients.

• Archives of Reconstructive Microsurgery
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• 제4권1호
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• pp.58-64
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• 1995

사지의 연부조직 결손으로 고려대학교 의과대학 정형외과학 교실에서 입원했던 12명의 환자 13례에 대하여 전완부 유리 피판술을 시행 후 최저 3개월에서 최고 37개월간 평균 14.3개월간 추시하여 다음과 같은 결론을 얻었다. 1. 13례 전례에서 연부조직 결손의 치료로 만족할만한 결과를 얻었다. 2. 이식피판의 크기는 평균 $54cm^2$였으며 유리피판의 평균 혈류 차단시간은 74분 이었다. 3. 술후 3례에서 합병증이 발생하였으며 3례중 2례는 동맥 문합부위에 혈전이 발생하였으나 술후 제 2일에 혈전 재거술을 시행하여 해결하였으며, 1례는 이식 정막내의 혈전으로 이식피판의 표층괴사가 발생하여 고식적인 피부이식술로 치료하였다. 4. 체중 부하를 받는 족저부의 재건에는 감각신경을 포함한 전완부 유리피판술이 좋은 방법의 하나이다. 5. 전완부 피판술은 비교적 넓은 연부조직 결손을 치료할 수 있고 이식 혈관의 내경이 커서 문합이 비교적 쉬워 숙련된 미세수술 수기를 익힌 외과의사에게는 성공률이 높은 유리피판술 중의 하나이다.