Transcript PPT

RADIAL FOREARM AND
RECTUS ABDOMINIS FREE
FLAP RECONSTRUCTION
Ravi Pachigolla, MD
Anna Pou, MD
History of Microvascular Free
Flap Reconstruction
Radial Forearm Free Flap
Reconstruction
Patient Selection
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Age
Co-existing Diseases
Nutritional Status
Defect Status
Preoperative Planning
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Allen Test
Defect assessment
Anatomy of Radial Forearm Flap
Flap elevation
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Tourniquet
Two team approach
Pedicle length
Sensory innervation
Advantages
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Two team approach
Sensory innervation
Flexibility
Disadvantages
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Need for skin graft
Sensory loss
Occasional functional deformity
Dominant Radial Artery
RECTUS ABDOMINIS FREE
FLAP
Patient Selection
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Prior Abdominal Surgery
Obesity
Nutritional Factors
Flap Elevation
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Large Skin Paddle
Preservation of Anterior Rectus Fascia
below arcuate line
Anatomy of Rectus Abdominis
Free Flap
Advantages
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Two team approach
Large skin paddle
Reliable Surgical Technique
Large vessel Diameter
Disadvantages
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Potential for hernia formation
Skin overly thick
No sensory innervation
POTENTIAL RECIPIENT
SITES
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Oromandibular Defects
Cranial Base Defects
Lip Defects
Facial Defects
SUMMARY AND
CONCLUSION