AnAtomic study of lAterAl Arm flAp with retrogrAde flow

The cutaneous coverage of extensive lesions of the forearm, from its middle third to the wrist, is still a challenge in reconstructive surgery.1-4 The flexor and extensor tendons of the fingers and of the wrist, the median, ulnar and radial nerves, the radius and the ulna are vulnerable to lesions of greater energy, such as exposed fractures and extensive wounds. Coverage procedures through rotation of local flaps represent a solution that is often impracticable due to the lesions of the vessels that supply them. The microsurgical free flaps of the arm, the contralateral forearm, the back or the abdomen were described in an attempt to resolve this problem. These procedures require ample dissections in two different surgical fields and the sacrifice of important vessels. There is a need for vascular microanastomoses, with their technical difficulties and vulnerability.1 One option for the coverage of distal forearm and wrist lesions is the lateral arm flap, with the proximal pedicle elongated by the “Y-V” technique, described by Martin.2 (Figure 1) The flap is aBSTRaCT