The radial forearm snake flap: An underutilized technique for fasciocutaneous and osteocutaneous forearm flaps with primary closure

Authors

Thomas G. Gessert, Department of Otolaryngology-Head and Neck Surgery, University of Kansas, Kansas City, Kansas, USA.
Zachary E. Pflum, Advocate Aurora HealthFollow
James D. Thompson, Department of Otolaryngology Head & Neck Surgery, Spectrum Health, Grand Rapids, Michigan, USA.
Matthew R. Hoffman, Division of Otolaryngology, Department of Surgery, University of Utah, Salt Lake City, Utah, USA.
Ruston Sanchez, Sanchez Plastic Surgery, Baton Rouge, Louisiana, USA.
Tiffany A. Glazer, Division of Otolaryngology, Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Aaron M. Wieland, Division of Otolaryngology, Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Timothy M. McCulloch, Division of Otolaryngology, Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin, USA.
Gregory K. Hartig, Division of Otolaryngology, Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin, USA.

Recommended Citation

Gessert TG, Pflum ZE, Thompson JD, et al. The radial forearm snake flap: An underutilized technique for fasciocutaneous and osteocutaneous forearm flaps with primary closure. Head Neck. 2022;44(5):1106-1113. doi:10.1002/hed.27004

Affiliations

Aurora St. Luke's Medical Center

Abstract

Background: The radial forearm free flap (RFFF) is associated with troublesome donor site morbidity related to split thickness skin grafting (STSG). The radial forearm snake flap with primary closure of the donor site may reduce donor site complications.

Methods: Single institution, retrospective cohort study comparing rates of delayed donor site wound healing and tendon exposure in 52 patients undergoing radial forearm snake flap and 95 patients undergoing conventional RFFF with STSG closure of the donor site.

Results: Tendon exposure occurred in zero (0%) patients undergoing snake flap and four (4.2%) patients undergoing conventional RFFF (0/52 vs. 4/95; p = 0.297). Delayed wound healing occurred in zero (0%) patients undergoing snake flap and 19 (20.0%) patients undergoing conventional RFFF (0/52 vs. 19/95; p < 0.001).

Conclusions: The radial forearm snake flap provides an alternative to conventional RFFF harvest, which enables primary donor site closure with reduced rates of delayed donor site healing.

Document Type

Article

PubMed ID

35165977