The Previously Grafted Forearm as a Source of Thin Free Flaps for Release of Neck Burn Contractures

Often, a better means to minimize recurrence after burn contracture release is by interposition of a thin, vascularized block of tissue. Such a flap should not disturb the normal contour to allow unrestricted function. If a local flap is unavailable, the forearm can be an excellent donor site for a thin free flap that also has the advantage of a long vascular pedicle. Unfortunately, in most major burn injuries, the upper extremities typically are involved and have been previously skin grafted. Nevertheless, the radial forearm free flap can be a possible option that should not be overlooked, as is demonstrated for neck resurfacing after burn contracture release. Another advantage of the radial forearm free flap is that the requisite regrafting of the forearm causes no new morbidity from an esthetic standpoint, which otherwise has been the major detriment of this donor site.