Ahn Hee Chang, Choi Matthew Seung Suk, Hwang Won Joong, Sung Kun Yong
Seoul, Korea From the Department of Plastic and Reconstructive Surgery, Hanyang University College of Medicine.
Plast Reconstr Surg. 2007 Jun;119(7):2153-2160. doi: 10.1097/01.prs.0000260704.34854.20.
In an attempt to improve the versatility of the radial forearm flap, a new design was developed: the transverse radial artery forearm flap.
The transverse radial artery forearm flap is designed elliptically in the distal palmar forearm with the long axis oriented transversely parallel to the wrist. The donor defect is closed by a V-shaped flap, which is elevated as a fasciocutaneous flap based on the ulnar artery by V-Y advancement. This second flap allows defect coverage without the need for a skin graft. From March of 1994 to February of 2005, the authors treated 39 patients with this flap. Free flaps were used in 36 patients and three patients were operated on with reverse pedicled flaps.
Twenty-five patients had head and neck defects, 11 patients had defects of the distal foot or great toe, and three patients had hand defects. In 13 cases, an osteocutaneous flap was elevated, and three flaps were transferred as sensate flaps. Maximum flap dimensions were 10 x 6 cm. The longest vascular pedicle in this series was 20 cm. All flaps survived. Except for two cases of delayed healing, no complications occurred at the donor site.
The transverse radial artery forearm flap is more versatile than the conventional radial flap, with the additional advantage of a long vascular pedicle. Its design allows for harvest of a piece of radial bone, which is pedicled on a completely different portion of the radial artery than the skin paddle. Thus, the setting of the bony portion can be chosen liberally. Donor-site morbidity is reduced, and the result is aesthetically pleasing.
为提高桡侧前臂皮瓣的通用性，研发了一种新的设计：桡动脉横支前臂皮瓣。
桡动脉横支前臂皮瓣在前臂远端掌侧设计为椭圆形，长轴横向平行于腕部。供区缺损通过一个V形皮瓣关闭，该V形皮瓣作为基于尺动脉的筋膜皮瓣通过V-Y推进掀起。这第二个皮瓣可覆盖缺损，无需植皮。1994年3月至2005年2月，作者用该皮瓣治疗了39例患者。36例患者采用游离皮瓣，3例患者采用逆行带蒂皮瓣手术。
25例患者有头颈部缺损，11例患者有足远端或拇趾缺损，3例患者有手部缺损。13例中掀起了骨皮瓣，3个皮瓣作为感觉皮瓣转移。皮瓣最大尺寸为10×6cm。本系列中最长的血管蒂为20cm。所有皮瓣均存活。除2例愈合延迟外，供区未发生并发症。
桡动脉横支前臂皮瓣比传统桡侧皮瓣更具通用性，还有血管蒂长的额外优势。其设计允许切取一块桡骨，该桡骨的血管蒂位于桡动脉与皮瓣完全不同的部分。因此，骨部分的位置可自由选择。供区发病率降低，且效果美观。
