The ulnar forearm free flap
Ellen M Van Cann
University Medical Center Utrecht, The Netherlands
: J Otol Rhinol
Abstract
The radial forearm free flap (RFFF) is frequently used for the reconstruction of soft-tissue defects in the head and neck area. The flap has thin and pliable skin, the vessels are of adequate length and diameter, and the flap is easy to harvest with high success rates. However, the ulnar forearm free flap (UFFF) has several advantages which make it an interesting alternative to the RFFF. The harvesting technique will be shown and our retrospective studies and one cadaver study are discussed. Our success rates of the UFFF exceeded 98%. Pressure perception, cold perception and strength of the donor-hand were better following the harvest of the UFFF compared to the RFFF. Acceptance of the donor scars was easier for the patients following the harvest of the UFFF compared to the RFFF because of excellent take of the skin graft on the ulnar side and the unnoticeable position on the forearm. The ulnar aspect of the forearm is often less hairy than the radial aspect. This is important as hair growth in the oral cavity or oropharynx may be inconvenient. In the cadaver study, the ulnar artery showed more perforators than the radial artery in the area close to the wrist. After injection of dye, the ulnar artery stained 77% of the skin surface area of the forearm, showing the UFFF to be more suitable than the RFFF for the restoration of large defects. We recommend the UFFF for the reconstruction of soft-tissue defects in the head and neck area.
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