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RADIAL FOREARM AND RECTUS ABDOMINIS FREE FLAP RECONSTRUCTION

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. Age Co-existing Diseases Nutritional Status Defect Status. Preoperative Planning.

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RADIAL FOREARM AND RECTUS ABDOMINIS FREE FLAP RECONSTRUCTION

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  1. RADIAL FOREARM AND RECTUS ABDOMINIS FREE FLAP RECONSTRUCTION Ravi Pachigolla, MD Anna Pou, MD

  2. History of Microvascular Free Flap Reconstruction

  3. Radial Forearm Free Flap Reconstruction

  4. Patient Selection • Age • Co-existing Diseases • Nutritional Status • Defect Status

  5. Preoperative Planning • Allen Test • Defect assessment

  6. Anatomy of Radial Forearm Flap

  7. Flap elevation • Tourniquet • Two team approach • Pedicle length • Sensory innervation

  8. Advantages • Two team approach • Sensory innervation • Flexibility

  9. Disadvantages • Need for skin graft • Sensory loss • Occasional functional deformity • Dominant Radial Artery

  10. RECTUS ABDOMINIS FREE FLAP

  11. Patient Selection • Prior Abdominal Surgery • Obesity • Nutritional Factors

  12. Flap Elevation • Large Skin Paddle • Preservation of Anterior Rectus Fascia below arcuate line

  13. Anatomy of Rectus Abdominis Free Flap

  14. Advantages • Two team approach • Large skin paddle • Reliable Surgical Technique • Large vessel Diameter

  15. Disadvantages • Potential for hernia formation • Skin overly thick • No sensory innervation

  16. POTENTIAL RECIPIENT SITES • Oromandibular Defects • Cranial Base Defects • Lip Defects • Facial Defects

  17. SUMMARY AND CONCLUSION

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