Eur J Plast Surg (1998) 21:286±289  Springer-Verlag 1998 ORIGINAL M. Emirog Ælu Analysis of radial forearm free flaps in 37 consecutive cases Received: 21 October 1996 / Accepted: 29 January 1997 Presented at the 11th Congress of the International Confederation for Plastic, Reconstructive and Aesthetic Surgery, Yokohama, Japan, 16±21 April, 1995 M. Emirog Ælu ( ) ) Department of Plastic and Reconstructive Surgery, Ankara University Faculty of Medicine, Ankara, Turkey Mailing address: Bari Sitesi 77. Sk. No. 2, TR-06520 Ankara, Turkey Tel.: +90-312-285-6661; Fax: +90-312-285-3070 E-mail: emiroglu@superonline.com Abstract Thirty-seven radial forearm free flap transfers have been performed in a three year period. The results obtained have proven that the radial forearm free flap, a pioneer in free flaps, is going to keep its useful position in reconstructive procedures. Out of 37 cases there was only one total flap loss (2.7%). Other complications expe- rienced arose from the donor site; two partial skin graft losses and one transient radial nerve injury. Preparation of a better recipient bed for split skin grafting and appli- cation of silicone sheeting also reduced the morbidity of donor defect. Key words Forearm flap ´ Microsurgery ´ Free flap ´ Silicone sheet ´ Skin graft Introduction Radial forearm free flap (RFFF) has become one of the major choices in reconstructive procedures since its de- scription in Shenyang Military Hospital in China in 1978 [19]. It is a flap with a high survival rate, a wide range of indications, it is easy to raise and transfer, has pliable skin and a large, long and constant vascular pedi- cle. However, utilization of the flap has been criticized as it results in sacrificing a major artery and unsightly donor site scar. Yet for many surgeons it is a flap of choice in head and neck, especially in oral cavity reconstruction due to its durability [1, 6, 21]. In a period of three years, a total of 37 RFFF recon- structions have been performed and in this paper these cases are presented and analysed. Material and methods Thirty-seven cases were operated between 1993 and 1996. The age of the patients ranged between 15 and 82 years, 22 were males and 15 females. The RFFF was mostly used in head and neck reconstruction (70%), followed by lower extremity, upper extremity, and penis (Ta- ble 1). Free radial forearm flaps were used for the residual defects of ex- tensive resection of malignant tumors in 54% of patients, of which the majority were squamous cell carcinomas. The remainder were basal cell carcinoma with one case of orbital sarcoma. Soft tissue de- fects caused by trauma or by resection and exposed tibial implants were performed as well as reconstruction following resection of dis- abling burn contractures of the neck (Table 2). Table 1 Sites of application Head and neck 26 cases Oral cavity 11 Facial skin 4 Neck 6 Scalp 5 Others 11 cases Lower extremity 6 Upper extremity 3 Penile reconstruction 2 Total 37 cases Table 2 Preoperative evaluation Malignancy 20 cases Squamous cell carcinoma 12 Basal cell carcinoma 7 Liposarcoma 1 Traumatic defect 7 cases Exposure of tibial plates 6 cases Burn scar 4 cases