The Radial Forearm Flap In Reconstruction Of Upper Limb Injuries

* Elevate the flap from ulnar to radial side toward the FCR * Elevate flap from radial to ulnar side to the brachioradialis tendon. Ligate and divide the radial artery and venae comitantes distally. * incise the skin over the cephalic vein proximally to the cubital fossa. Identify the venous branching pattern and perforating vein. * Elevate the skin and subcutaneous paddles proximally off of the FCR and brachioradialis. * Define the venous anatomy at the cubital fossa. In most cases, the median basilic vein and continuation of the median vein contribution to the cephalic vein can be harvested proximal to the perforating vein. This anatomy allows two large veins to be harvested that drain both the deep and superficial systems. Occasionally, one large vein will be identified. * Closure is performed by harvesting a 0.018-inch skin graft to cover the donor defect. The radial skin edge should be advanced to cover the exposed radial nerve.