Thin Free Flap for Resurfacing of the Arm and Forearm

Abstract

Soft tissue reconstruction of the upper extremity especially at the joint area requires a thin and pliable flap for coverage to maximize the cosmetic outcome and facilitate early mobilization preventing joint stiffness. This case presents a patient with a myxofibrosarcoma at proximal forearm. After wide excision of the tumor, the defect extended from the proximal forearm to the elbow area. A free tissue transfer was chosen to maximize function and cosmetic appearance. Superficial circumflex iliac artery perforator (SCIP) flap was chosen in regard to thickness, ease of elevation, size, pliability of the flap and the superficial location of the recipient vessel. Early compression of the flap was performed postoperatively in this patient to reduce the edema, stabilize the flap during early ambulation and achieve good contour.