ABSTRACT
A modifed design for the distally-based radial forearm flap is presented, in an oblique
direction rather than longitudinally, based on the existence of skin laxity in the
proximal forearm region. The skin paddle of the flap is designed in an oblique fashion
pedicled on one of the proximal-row septocutaneous perforators, and elevated in the
usual manner supplied by the distal radial artery. The oblique radial forearm flap
thus created was successfully utilized for reconstruction of seven dorsal hand defects.
Results showed that all the flaps could easily be transposed to the defect through
a wide arc of rotation and all survived totally, with direct closure of the donor
site in five cases, and significant reduction in size in the remaining two cases.
It was concluded that the oblique design for the skin island of the reverse radial
forearm flap could allow creation of a flap that has a smaller donor defect and yet
presents a longer pedicle length, with a wider arc of rotation and better adaptation
to a dorsal hand defect, than a conventional longitudinal-design radial forearm flap.
KEYWORD
Radial forearm flap - oblique - reverse flow
