Radial Forearm Free Flap for Salvage of Achilles-Tendon Repair Wounds

ABSTRACT

-Achilles-tendon repair wounds are prone to breakdowns and secondary infections, compromising the integrity of the repair and the ultimate function of the repaired tendon. Unlike defects resulting from tumor excision, burns, or trauma, Achilles-tendon repair wounds have their own special considerations. The dissection needed for the repair of the tendon often denudes the tendon of the peritenon blood supply and creates a sub-tendinous dead space. Anatomic topography unique to the Achilles region makes the choice of flap coverage crucial in terms of function and cosmesis. Considering all the flap options utilized in the past, the radial forearm free flap is the most logical choice, offering the advantage of thin, supple, vascularized tissue. The flap can also be elevated easily for secondary reconstructions, when simultaneous tendon reconstruction and coverage are not possible. The authors present their experience utilizing the radial forearm flap as the flap of choice for salvage of the complicated wounds of Achilles tendon repair.