Correspondence and communication
The ulnar artery perforator based islanded V-Y flap closure of the radial forearm flap donor site

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Methods

Consecutive patients undergoing FRFF reconstruction of the oral cavity were considered for closure of the donor site using this method. All required wide excision of the primary tumour with accompanying neck dissection and reconstruction with free tissue transfer. In view of the need for thin pliable tissue the FRFF was chosen as the flap to reconstruct the defect. The flaps in each case were measured to fit the defect as 6 cm by 4 cm or 7 cm by 5 cm.

The FRFF flap was raised in the usual manner

Results

We performed the procedure on five consecutive cases. In all cases the flap was successfully advanced to close the defect with minimal tension. In two cases the flap was 7 cm by 5 cm. In these two cases, the large medial superficial veins and medial cutaneous nerve of the forearm were divided to allow the flap to advance and permit tension-free closure, but both these cases suffered oedema for approximately 1 month postoperatively. There was no delayed healing in any case and Figure 3 shows

Discussion

The FRFF remains a popular flap for head and neck reconstruction. Its main disadvantage is in donor site morbidity, and modifications have been made in closure of the donor site to good effect.2, 3, 4, 5, 6, 7 We present a further modification to facilitate donor site closure in the hope that donor site morbidity may be reduced still further. The advantages are with reduced tension on the wound and no dog ear on the ulnar aspect of the closure. Additionally, complete islanding of the flap on

References (7)

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