Experience with the island radial forearm flap in local hand coverage.

Use of the island radial forearm flap (RFF) for soft-tissue coverage of hand and forearm following mutilating injuries, chemotherapeutic injection sloughs, and tumor excisions are discussed. Twenty-eight flaps were used in 28 injured upper extremities. Partial flap loss occurred in three patients. Minor sloughing of the skin graft of the donor site occurred in four. Twelve patients had persistent dysesthesias and paresthesias in the injured extremity. All patients complained of some degree of weakness in the injured extremity. Our experience supports the use of this flap for local hand and forearm coverage when local tissue is unavailable and skin grafting is deemed inadvisable. Donor site problems have been acceptable in our patient population.