CC BY-NC-ND 4.0 · Laryngorhinootologie 2018; 97(S 02): S312-S313
DOI: 10.1055/s-0038-1640796
Plastische Chirurgie: Plastic Surgery

Morbidity of the Radial Forearm Flap: A calculable Risk?

N Mansour
1   HNO-Klinik, Klinikum rechts der Isar der TU München, München
E Scherer
2   Agaplesion Diakonieklinikum Rotenburg, Rotenburg
A Knopf
1   HNO-Klinik, Klinikum rechts der Isar der TU München, München
› Author Affiliations


The radial forearm flap (RFF) is the workhorse in the reconstructive head and neck surgery. Although, there is a donor site morbidity (DSM) and recipient side morbidity (RSM). The aim of this study is the evaluation of donor side and recipient side complications.


We analyzed retrospectively all patients that underwent surgery with an RFF from 2012 to 2016 in our hospital.


We included 95 patients. The RFF with its vascular pedicle is harvested with an additional pedicle of the cephalic vein. All microsurgical anastomoses were done by a simple interrupted suture technique. The artery was anastomoses in 88 times to the superior thyroid artery, 3 times to the facial artery, 2 times to lingual artery, 1 time to the external carotid artery, 1 time to the transverse cervical artery. In 90 patients, we anastomosed 3 veins (2 venae comitantes+1 cephalic vein), in 5 patients, we anastomosed 2 veins (1 vena comitans+1 cephalic vein). All patients received 5000 IE heparin subcutaneously during surgery. Anticoagulation was continued 10 days after surgery. The donor side defect required a full-thickness skin graft in 71 patients, a split-thickness skin graft in 24 patients. We had complications in 28% of the patients. We had no thrombosis in any anastomoses, but flap necrosis occurred in 2 patients (2%). Revision surgery because of hematoma was done in 10 patients, 6 patients showed wound healing deficits in the circumference of the RFF, 6 patients showed wound healing deficits at the donor site, 5 patients had further small complications.


Flap necrosis can be reduced by 3 venous anastomoses and early revision surgery in case of cervical hematoma. The reduction of donor side morbidity should be focused on in the future.

Publication History

Publication Date:
18 April 2018 (online)

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