Abstract：
BACKGROUND: The medial arm flap (MAF) has been used as a pedicle flap and free flap to reconstruct various deformities, including those of the head and neck, axilla, elbow, chest, and hand. This study reviews the anatomy of the flap, the technique of flap harvest, its clinical applications, and a systematic review of the current published literature.
METHODS: An online systematic review of MEDLINE, EMBASE, PubMed, and The Cochrane Library from inception to September 30, 2023, was completed. Studies that investigate the anatomy, technique or clinical outcomes of medial arm flaps were included. Clinical data extracted includes patient, defect, flap characteristics, complications, and take-back procedures. Anatomic data extracted includes anatomical variations, and vascular characteristics and patterns.
RESULTS: Between 1980 and 2023, 50 papers were published outlining the medial arm flap. Anatomic studies detail the anatomy of 384 medial arms, and outcomes are reported for 283 MAFs (75 free flaps and 208 pedicle flaps). The superior ulnar collateral artery is most commonly cited as the dominant arterial supply to the middle third of the medial arm. The majority of patients required reconstruction post-burn (39.2%), trauma (17.7%), and tumor excision (12.4%). MAFs were mostly used to reconstruct defects of the head and neck (41.7%), the hand and wrist (21.9%), and the elbow (16.3%). Eleven flaps (4.1%) suffered partial flap failure, and two flaps (0.7%) suffered total flap failure.
CONCLUSIONS: This manuscript demonstrates that the MAF is a reliable and underutilized flap option with a well-hidden donor scar and a low complication rate.
METHODS: An online systematic review of MEDLINE, EMBASE, PubMed, and The Cochrane Library from inception to September 30, 2023, was completed. Studies that investigate the anatomy, technique or clinical outcomes of medial arm flaps were included. Clinical data extracted includes patient, defect, flap characteristics, complications, and take-back procedures. Anatomic data extracted includes anatomical variations, and vascular characteristics and patterns.
RESULTS: Between 1980 and 2023, 50 papers were published outlining the medial arm flap. Anatomic studies detail the anatomy of 384 medial arms, and outcomes are reported for 283 MAFs (75 free flaps and 208 pedicle flaps). The superior ulnar collateral artery is most commonly cited as the dominant arterial supply to the middle third of the medial arm. The majority of patients required reconstruction post-burn (39.2%), trauma (17.7%), and tumor excision (12.4%). MAFs were mostly used to reconstruct defects of the head and neck (41.7%), the hand and wrist (21.9%), and the elbow (16.3%). Eleven flaps (4.1%) suffered partial flap failure, and two flaps (0.7%) suffered total flap failure.
CONCLUSIONS: This manuscript demonstrates that the MAF is a reliable and underutilized flap option with a well-hidden donor scar and a low complication rate.
摘要：
背景：臂内侧皮瓣（MAF）已被用作椎弓根皮瓣和游离皮瓣，以重建各种畸形，包括头部和颈部，腋下,弯头,胸部，和手。本研究回顾了皮瓣的解剖结构，皮瓣收获技术，其临床应用，并对当前已发表的文献进行了系统的回顾。
方法：MEDLINE的在线系统评价，EMBASE,PubMed,从成立到2023年9月30日的Cochrane图书馆已经完成。研究解剖学，包括臂内侧皮瓣的技术或临床结果。提取的临床数据包括患者、缺陷,襟翼特性，并发症,和收回程序。提取的解剖数据包括解剖变异，血管特征和模式。
结果：在1980年至2023年之间，发表了50篇论文，概述了内侧臂皮瓣。解剖学研究详细介绍了384个内侧臂的解剖结构，结果报告了283MAFs（75个游离皮瓣和208个带蒂皮瓣）。尺上侧支动脉最常被引用为内侧臂中三分之一的主要动脉供应。大多数患者需要烧伤后重建（39.2%），外伤(17.7%),和肿瘤切除（12.4%）。MAFs主要用于重建头颈部缺损（41.7％），手及手腕(21.9%),和弯头(16.3%)。11个皮瓣(4.1%)出现部分皮瓣失效,两个襟翼（0.7％）发生了完全的襟翼故障。
结论：该手稿表明MAF是一种可靠且未充分利用的皮瓣选择，其供体瘢痕隐藏良好，并发症发生率低。
方法：MEDLINE的在线系统评价，EMBASE,PubMed,从成立到2023年9月30日的Cochrane图书馆已经完成。研究解剖学，包括臂内侧皮瓣的技术或临床结果。提取的临床数据包括患者、缺陷,襟翼特性，并发症,和收回程序。提取的解剖数据包括解剖变异，血管特征和模式。
结果：在1980年至2023年之间，发表了50篇论文，概述了内侧臂皮瓣。解剖学研究详细介绍了384个内侧臂的解剖结构，结果报告了283MAFs（75个游离皮瓣和208个带蒂皮瓣）。尺上侧支动脉最常被引用为内侧臂中三分之一的主要动脉供应。大多数患者需要烧伤后重建（39.2%），外伤(17.7%),和肿瘤切除（12.4%）。MAFs主要用于重建头颈部缺损（41.7％），手及手腕(21.9%),和弯头(16.3%)。11个皮瓣(4.1%)出现部分皮瓣失效,两个襟翼（0.7％）发生了完全的襟翼故障。
结论：该手稿表明MAF是一种可靠且未充分利用的皮瓣选择，其供体瘢痕隐藏良好，并发症发生率低。
