Use of the Medial Upper Arm Skin as an Arterialised Flap

Abstract

The skin on the underside of the upper arm is supplied in part by the superior ulnar collateral artery, a direct cutaneous artery arising from the brachial artery four to six cm distal to the pectoralis major insertion. Two-thirds to three-quarters of the length of the medial arm skin can be reliably transferred as an arterialized undelayed pedicle flap. This skin provides excellent coverage for the opposite hand from a relatively inconspicuous donor site. Transfer of this flap is safe and patient discomfort is minimal. It is recommended for elective reconstruction and emergency procedures.