Donor-Site Morbidity of the Sensate Extended Lateral Arm Flap

Department of Plastic, Reconstructive, and Aesthetic Surgery, University Hospital of Basel, Basel, Switzerland.
Journal of Reconstructive Microsurgery (Impact Factor: 1.31). 09/2011; 28(2):133-8. DOI: 10.1055/s-0031-1289165
Source: PubMed


The free extended lateral arm flap (ELAF) has gained increasing popularity thank to its slimness and versatility, longer neurovascular pedicle, and greater flap size when compared with the original flap design. The aim of this study was to assess the donor-site morbidity associated with this extended procedure. A retrospective study of 25 consecutive patients analyzing postoperative complications using a visual analogue scale questionnaire revealed high patients satisfaction and negligible donor-site morbidity of the ELAF. Scar visibility was the commonest negative outcome. Impaired mobility of the elbow had the highest correlation with patient dissatisfaction. Sensory deficits or paresthetic disorders did not affect patient satisfaction. The extension of the lateral arm flap and positioning over the lateral humeral epicondyle is a safe and well-accepted procedure with minimal donor-site morbidity. To optimize outcomes, a maximal flap width of 6 or 7 cm and intensive postoperative mobilization therapy is advisable.

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    • "To further avoid injury to the radial nerve, the vascular pedicle was isolated precisely under the moderate tensile force of a rubber band. One study showed that numbness and hypoesthesia can occur even when the posterior arm or forearm cutaneous nerve was preserved, but that these symptoms would resolve gradually[22]. The patients in our study who reported pain at the lateral epicondyle and hypoesthesia at the lateral aspect of the proximal forearm also reported that these symptoms gradually resolved. "
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