The free radial forearm flap for reconstruction of facial defects in noma patients

Abstract 

Within a 2-year period ten patients aged 5–22 years were treated for facial sequelae of noma. In six cases free radial forearm flaps were used, combined with local and regional flaps. The indications were defects located in the midface and perioral area. There were no free or regional flap losses in this series. The aesthetic and functional results were appreciated by the patients and there were no functional problems related to the donor area because a suprafascial flap dissection technique was used. In our experience the free radial forearm flap is a valuable option for facial reconstruction in NOMA cases. The advantages include: (1) A very long and large calibre pedicle; (2) thin and pliable flaps of variable size and configuration; (3) the possibility of single stage reconstruction in selected cases. The disadvantages include the not always ideal colour match, both in black patients and in white, and the unsightly donor area which, however, has never led to functional problems.