Perforator Based Reverse Radial Artery Forearm Flap (Prraff): Anatomical Studies and Clinical Applications

A perforator based reverse radial artery forearm flap has been used from the volar and radial aspect of the distal forearm for coverage of raw areas near the wrist, distal forearm and hand in six cases. This was preceded by an anatomical study in ten cadaveric limbs concentrating on the position and size of the subcutaneous perforators from the radial artery in the distal half of the forearm. It revealed that there are constant perforators from the radial artery situated approximately 1, 3 and 7 cm. proximal to the radial styloid process and flaps could be raised based on the 1 cm and 3 cm perforators. We found this to be a reliable flap to cover small raw areas near the wrist and the proximal part of the hand, the main advantage being not sacrificing the main trunk of the radial artery.