Monitoring the free radial forearm flap in pharyngo-oesophageal reconstruction.

Monitoring the viability of the free radial forearm flap after pharyngo-oesophageal reconstruction poses technical problems. A method of monitoring using a small island flap elevated distal to the main forearm flap is presented. This monitor flap is easy to elevate. It is placed externally and provides information about the perfusion of the buried reconstruction flap. Postoperative management requires only assessment of tissue colour, turgor, capillary refill and bleeding, as for standard skin flap monitoring.