Prelamination of Radial Forearm Free Flap with Buccal Mucosa

Abstract

Objective: 1) To describe a new technique for prefabricating a fasciomucosal flap on the forearm. 2) To report initial outcomes of reconstruction using this technique for small oral defects. 3) To learn how to apply and customize the prelaminated radial forearm fasciomucosal flap for reconstruction of the head and neck.

Method: This is a case series of 3 patients who underwent reconstruction with a prelaminated radial forearm fasciomucosal flap for small lip or oropharyngeal defects at a tertiary referral center from September 2011 to December 2011. Initial clinical outcomes are described and patient photographs are shown.

Results: We prelaminated and successfully transferred 3 flaps in 3 male patients ranging in age from 46 to 53 years. These patients required reconstruction of a lip (n = 1) or oropharyngeal (n = 2) defect after removal of a head and neck arteriovenous malformation (n = 2) or cancer (n = 1). All flaps were prelaminated utilizing morcelized buccal mucosa grafts. Second stage transfer typically occurred approximately 2 to 3 weeks after prelamination. There were no intraoperative complications and no postoperative bleeding, infection, or flap failures. Reconstruction was stable and satisfactory at a range of 2-5 months following surgery.

Conclusion: The prelaminated radial forearm fasciomucosal flap using morcelized buccal mucosa for aerodigestive defects minimizes donor site morbidity and allows for mucosal restoration. A larger multisite study will provide more information on clinical outcomes.