PubMed · 7824124
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R C Katzin. 1995. Arm rolling test.. https://doi.org/10.1212/wnl.45.1.203-a
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A disadvantage of the radial forearm flap is the removal of skin from a functionally important and aesthetically exposed region. To minimize the donor site morbidity with this flap, we have thus far used a two-phase procedure for intraoral defect coverage in 15 patients: In a first step, a 0.5-mm split thickness skin graft is transplanted to the forearm fascia and settles there over a period of 2 weeks. In step two, the prefabricated fascial-split thickness skin graft can be raised with complete preservation of the forearm skin and microsurgically transferred like a conventional radial forearm flap. We have obtained the following results with this procedure: (1) All skin grafts took completely on the forearm fascia. (2) Prefabricated fascial-split thickness skin flaps could be raised like conventional radial forearm flaps. (3) The very thin and moldable flaps were excellently suited for intraoral lining and showed complication-free healing. We conclude that tension-free, primary closure of the donor site can be achieved with minimal aesthetic and functional impairment.
The anatomy of the venous system in the pedicles of the radial forearm and anterior tibial reverse flow flaps was investigated in fresh cadavers (n = 6) and their drainage pathways were observed in a radiographic perfusion study of the veins of 2 radial forearm and 2 anterior tibial pedicles. The venous system was found to consist mainly of three types of veins: venae comitantes, communicating veins between the venae comitantes, and vasa vasorum. Valves were identified in all three types of vein. In the venous system, including the vasa vasorum, there was no route of reverse flow that did not pass directly through valves. Valve incompetence was demonstrated in the radiographic perfusion study. However, valve incompetence did not occur in all valves and a difference in valve resistance against reverse flow pressure existed. Veins with relatively weak valve resistance became the drainage pathway. A possible cause of the difference in valve resistance was differences in the anatomy of the valve sinuses.
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