The preexpanded radial free flap.

The experimental basis for free-flap preexpansion is briefly discussed. Two cases are reported in which the ankle/heel area was resurfaced and reinnervated with a preexpanded radial flap. The size of the first flap was half the surface area of the entire forearm. Direct closure of the secondary defect was possible with a single scar and without functional deficit in both cases. The flaps were well-vascularized and consisted of the sensory distribution of one peripheral nerve division, which was anastomosed in the recipient site. This preparation proved to be finer and to have better contouring capacity and skin quality than existing alternatives. It is clear that hydraulic tissue expansion facilitates great additional use of the radial flap as well as a range of other modified free flaps when there is time available for the flap to be developed prior to transfer.