Pre-expanded Brachial Artery Perforator Flap

The medial upper arm flap is a time-honored yet ignored technique. It may be revitalized by combining the techniques of tissue expansion and perforator flap surgery. Pre-expansion increases flap dimension, remodels flap vasculature, and reduces donor site morbidities, making the medial arm flap a more effective option for various defect reconstructions. A pre-expanded brachial artery perforator flap achieves excellent functional and aesthetic outcomes in patients with soft tissue defects on the head and neck, axilla, chest wall, and upper extremity. Although this technique requires multiple procedures, each operation is relatively simple and has a low complication rate when properly performed.

Key points

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Brachial artery perforator flap is a flap based on septocutaneous perforators derived from the brachial artery, which is harvested from the medial upper arm.
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The brachial artery perforator flap is commonly used as a pedicled flap for defect reconstruction in different locations, including the head and neck, axilla, chest wall, and upper extremity.
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Many of the disadvantages of the pedicled brachial artery perforator flap can be overcome by pre-expansion of the flap.
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As there is no need to dissect the perforators through the muscle, the pre-expanded pedicled brachial artery perforator flap is quite reliable and easily to be raised.