Distally Based Radial Artery Perforator Flaps

Which Factors Correlate with the Flap Survival? Four Case Reports

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We report four cases of successful resurfacing with radial artery perforator flaps. Two flaps fully survived, and the remaining two flaps developed partial necrosis in the distal and middle parts, which healed through secondary intension. Several factors, including the number of perforators, location of the perforator, flap length, flap length/width ratio, and involvement of the cutaneous sensory nerve were reviewed retrospectively, and the correlations between these factors and flap survival were statistically analyzed, without any significant correlations. However, the two flaps that developed partial necrosis were larger and longer than the other two, suggesting that the size of the two flaps outsized the angiosomes of the perforators. Intraoperative near-infrared fluorescence angiography with intravenous administration of indocyanine green is a promising technique for preventing flap failure due to vascular disorders.