ABSTRACT
The fasciocutaneous radial forearm free flap (RFFF) has been a frequently deployed option for head and neck reconstructive surgeons for four decades. The RFFF provides a moderate area of the thinnest and most pliable lining of all the fasciocutaneous flap donor sites. There are few absolute contraindications except for those rare individuals who have an inadequate collateral arterial supply to the hand. Patients with Raynaud’s disease and scleroderma may be at increased risk of hand ischaemia. Previous surgery to the forearm, including distal radius fracture repair, are regarded as relative contraindications. A modified Allen test is performed to ensure adequate collateral circulation with careful inspection of the thumb and index finger. The arterial supply of the fasciocutaneous forearm flap relies on perforator vessels from the radial artery as it lies in the lateral intermuscular septum. The venous drainage of the forearm flap is via both a deep venae comitantes and a superficial venous system, which interconnect.
