for Upper Limb Soft Tissue Coverage
Conditions
Brief summary
The radial forearm flap is a very useful and versatile flap with a long vascular pedicle and a thin, pliable skin. It's used in reconstruction of the mutilated hand as a reverse pedicled flap. The dominant pedicle is the radial artery, with venous outflow through the dual system of the venae comitantes and cephalic vein. Sensory innervation may be derived from the medial and lateral antebrachial cutaneous nerves. The radial forearm flap offers the advantage of a large area of donor tissue from the involved extremity with the potential for inclusion of bone, nerve, and tendon grafts. Sacrifice of the radial artery has not been associated with significant patient symptoms However, the donor defect can be troublesome, frequently requiring skin grafting directly over the paratenon of the flexor tendons, producing an undesirable donor site appearance
Interventions
PROCEDURERadial Forearm Flap
* Elevate the flap from ulnar to radial side toward the FCR * Elevate flap from radial to ulnar side to the brachioradialis tendon. Ligate and divide the radial artery and venae comitantes distally. * incise the skin over the cephalic vein proximally to the cubital fossa. Identify the venous branching pattern and perforating vein. * Elevate the skin and subcutaneous paddles proximally off of the FCR and brachioradialis. * Define the venous anatomy at the cubital fossa. In most cases, the median basilic vein and continuation of the median vein contribution to the cephalic vein can be harvested proximal to the perforating vein. This anatomy allows two large veins to be harvested that drain both the deep and superficial systems. Occasionally, one large vein will be identified. * Closure is performed by harvesting a 0.018-inch skin graft to cover the donor defect. The radial skin edge should be advanced to cover the exposed radial nerve.
Sponsors
Sohag University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
5 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
* patients aging 5 to 80 years. * Soft Tissue defects following MCA injuries. * Defect size less than 30 cm
Exclusion criteria
* Peripheral vascular disease * Underling bone osteomyelitis * Unhealthy skin of volatile aspect of donor forearm * Defect more than 30 cm * Ulnar artery previous ligated
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Viability of the flap | 12 months | viability of the flap including color, warmth, capillary refill, smell and turgor |
Countries
Egypt
Outcome results
None listed