An Alternative Method of the Direct Closure for the Radial Forearm Flap Donor-Site Defect: Lazy S Double-Opposing Rotation Flaps

The free radial forearm flap remains a workhorse flap for head and neck reconstruction, although perforator flap or super microsurgery has become increasingly popular. Yet donor-site morbidities, including unsightly appearances that may occur when sites are closed via skin graft, cause reconstructive surgeons to be hesitant to use the forearm flap. Elliot et al (1988) reported the direct closure method for donor-site defects of the radial forearm flap using the V–Y flap, and several modifications have been reported based on their methods.[1] [2] [3] [4] [5] [6] [7] [8] However, partial skin necrosis sometimes occurs along the lateral side of the flap even though the perforators from ulnar artery are preserved well, and this necrosis leaves ugly wide scarring on patients' forearms ([Fig. 1]). To minimize these drawbacks, simple lazy S double-opposing rotation flaps were designed for the donor site of the radial forearm flap, and the donor-site defect was closed directly. In this report, the details of the method and the outcomes are described.

Fig. 1 Partial skin necrosis along the lateral side of the flap in V–Y flap closure.

• References

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