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 Age Co-existing Diseases Nutritional Status Defect Status

Preoperative Planning Allen Test Defect assessment

Anatomy of Radial Forearm Flap

Flap elevation Tourniquet Two team approach Pedicle length Sensory innervation

Advantages Two team approach Sensory innervation Flexibility

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

RECTUS ABDOMINIS FREE FLAP

Patient Selection Prior Abdominal Surgery Obesity Nutritional Factors

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

Anatomy of Rectus Abdominis Free Flap

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

Disadvantages Potential for hernia formation Skin overly thick No sensory innervation

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

SUMMARY AND CONCLUSION