Figure 1

A 50 year old female presented with recurrent, poorly differentiated squamous cell carcinoma. A radical excision of the lesion, including removal of the outer table, was performed (A). A subfascial dissection of the radial forearm flap was performed with preservation of the radial nerve (B). A subcutaneous tunnel was created to access the temporal vessels (C). The harvested radial forearm free flap measured 6 x 12 cm (D). The radial forearm free flap was inset in the scalp over a drain using interrupted sutures (E). A split thickness skin graft harvested from the thigh was used to cover the donor site (F). Two weeks post-reconstruction the recipient and donor sites were healthy without evidence of flap or graft loss (G, H). Following radiation therapy the radial forearm free flap was well healed and maintained good contour (I)