Reconstruction of Suborbital area using Composite Radial Forearm Free Flap with Palmaris Longus Tendon immediately after Wide Excision of Skin Cancer

Journal of the Korean Society for Surgery of the Hand 2001;10(1):60-63.
Published online May 31, 2001.

Hyun Taek Lee, M.D., Kyoung Won Minn, M.D.

피부 악성 종양 절제 후 장장근건을 포함한 복합 요골 전완 유리 피판술을 이용한 중안면부의 재건

이현택·민경원

Abstract

  The reconstruction of the suborbital area followed by resection of skin cancer has been used many methods including skin graft, local flaps, free flaps, and skin expansion. The radial forearm free flap has become a workhorse flap in this area because of its lack of bulk, ease of dissection, malleability, and hairlessness. When the suborbital defect especially including full-thickness defect of lower lid was reconstructed with many free flaps, the ectropion and the deformity of medial and lateral canthal area were common problems encountered as late complication due to gravitational descent. To improve the final aesthetic result in patients with suborbital defect, the radial forearm free flap was elevated as a composite radial forearm - palmaris longus free flap, in which the vascularized palmaris longus tendon was included and anchored to the periorbital bone with mitek® as sling, to suspend the flap against gravity and inferior descent, and thereby creating a more natural cheek contour. Two clinical cases were presented as an example of this procedure. Postoperative results emphasize the importance of suspension sling with palmaris longus tendon using mitek® in reconstruction of the suborbital defect with radial forearm free flap.

Key Words: Composite radial forearm - palmaris longus free flap, Suborbital reconstruction,Mitek<, sup>, ®, <, /sup>