{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T19:39:52Z","timestamp":1781120392533,"version":"3.54.1"},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,6,13]],"date-time":"2023-06-13T00:00:00Z","timestamp":1686614400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The radial forearm free flap (RFFF) is still one of the most used free flaps to repair soft tissue defects of the head and neck. Among its main drawbacks, it presents severe donor site complications. We report our experience about the use of free\u2010style propeller ulnar artery perforator flaps (UAP) to repair RFFF donor site.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>From February 2010 to June 2020, six patients who underwent immediate tongue reconstruction with RFFF after cancer excision, had the donor site at the forearm reconstructed with a free\u2010style propeller UAP flap. The indication for a UAP flap was based on defect size and the presence of tendons or radial nerve exposure. Ulnar artery perforators were identified intra\u2010operatively with a handheld Doppler. The UAP flaps were harvested and rotated to cover donor site defects. The patients' mean age was 59, ranging from 49 to 65\u2009years old. The defects size ranged from 8\u201312\u2009cm\u2009\u00d7\u20095\u20137\u2009cm with a mean size of 10.5\u2009\u00d7\u20096.7\u2009cm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The UAP flap harvested ranged from 8\u201311\u2009cm\u2009\u00d7\u20095\u20137\u2009cm with a mean size of 10.5\u2009\u00d7\u20095.5\u2009cm. The perforators, identified with a power Doppler, were located at the middle third of the forearm. Flaps' rotation varied from 90 to 160\u00b0 with a mean rotation of 122\u00b0. Mean operating time was 60\u2009min ranging from 40 to 75\u2009min for UAP flap elevation. No flap necrosis or tendon exposure occurred. One case of wound dehiscence was reported. Two out of six patients suffered from tendon adhesions to the flap. UAP flap donor site was primarily closed in four out of six patients, whereas two cases required a split\u2010thickness skin grafts. Mean donor site healing time was about 20\u2009days (19.8\u2009days) ranging from 14 to 30\u2009days. Follow\u2010up ranged from 12 to 31\u2009months with a mean follow up time of 19\u2009months (18.6\u2009months). At 6\u2009months follow\u2010up only one patient experienced a functional limitation of wrist and finger joints extension of 20\u00b0 which required tenolysis. At the end of the patient's follow up that is 22\u2009months, the range of movement was within normal limits. In our casuistry neuropathic pain was absent.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>RFF is still a paramount tool in reconstructive surgery but its donor site is still burdened by a high complication rate. Free\u2010style UAP flaps can provide a local and safe solution.<\/jats:p><\/jats:sec>","DOI":"10.1002\/micr.31074","type":"journal-article","created":{"date-parts":[[2023,6,14]],"date-time":"2023-06-14T05:13:44Z","timestamp":1686719624000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Free\u2010style propeller ulnar artery perforator flaps for radial forearm flap donor site repair"],"prefix":"10.1002","volume":"44","author":[{"given":"Andrea","family":"Marchesi","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery Hand Surgery and Reconstructive Microsurgery, Ospedale San Gerardo\u2010ASST Monza  Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8709-1042","authenticated-orcid":false,"given":"Arianna","family":"Gatto","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Hand Surgery and Reconstructive Microsurgery, Ospedale San Gerardo\u2010ASST Monza  Monza Italy"},{"name":"Plastic, Reconstructive and Aesthetic Surgery University of Pavia  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica M.","family":"Cavalli","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Hand Surgery and Reconstructive Microsurgery, Ospedale San Gerardo\u2010ASST Monza  Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Del Bene","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Hand Surgery and Reconstructive Microsurgery, Ospedale San Gerardo\u2010ASST Monza  Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,6,13]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anorl.2015.06.003"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0041-1735508"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2021.09.028"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000006790"},{"issue":"1","key":"e_1_2_9_6_1","first-page":"66","article-title":"Repair of skin and soft tissue defects of auricle and donor site with relay flap","volume":"33","author":"Chang S.","year":"2019","journal-title":"Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199493030-00016"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e318295896c"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.26491"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-5182(05)80394-4"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2007.07.004"},{"issue":"1","key":"e_1_2_9_12_1","first-page":"E945","article-title":"Short\u2010term donor site morbidity: A comparison of the anterolateral thigh and radial forearm fasciocutaneous free flaps","volume":"38","author":"Knott P. 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