RADIAL FOREARM AND RECTUS ABDOMINIS FREE FLAP RECONSTRUCTION Ravi Pachigolla, MD Anna Pou, MD

History of Microvascular Free Flap Reconstruction

Radial Forearm Free Flap Reconstruction

Patient Selection s Age s Co-existing Diseases s Nutritional Status s Defect Status

Preoperative Planning s Allen Test s Defect assessment

Anatomy of Radial Forearm Flap

Flap elevation s Tourniquet s Two team approach s Pedicle length s Sensory innervation

Advantages s Two team approach s Sensory innervation s Flexibility

Disadvantages s Need for skin graft s Sensory loss s Occasional functional deformity s Dominant Radial Artery

RECTUS ABDOMINIS FREE FLAP

Patient Selection s Prior Abdominal Surgery s Obesity s Nutritional Factors

Flap Elevation s Large Skin Paddle s Preservation of Anterior Rectus Fascia below arcuate line

Anatomy of Rectus Abdominis Free Flap

Advantages s Two team approach s Large skin paddle s Reliable Surgical Technique s Large vessel Diameter

Disadvantages s Potential for hernia formation s Skin overly thick s No sensory innervation

POTENTIAL RECIPIENT SITES s Oromandibular Defects s Cranial Base Defects s Lip Defects s Facial Defects

SUMMARY AND CONCLUSION