Version June 2024
| Flap name | Type | Vascular supply | Pedicle length | Soft tissue quality | Common uses | Advantages |
| Radial forearm | Fasciocutaneous | Radial artery | 14 to 21 cm | Thin and pliable. Can be harvested with cuff of adipose (beavertail) attached. | Partial and hemiglossectomy defects, oral cavity defects requiring thin tissue | Long pedicle, thin and pliable tissue, reliable perforator anatomy |
| Ulnar forearm | Fasciocutaneous | Ulnar artery | 6 to 15 cm | Thin and pliable, often less adipose than radial forearm | Partial and hemiglossectomy defects, oral cavity defects requiring thin tissue | Donor site can be more disguised due to proximal location of perforators. Can be used in radial dominant hands where radial forearm is not an option. |
| Anterolateral thigh | Musculocutaneous, can be fasciocutaneous and perforator based | Descending branch of lateral femoral circumflex artery | 8 to 16 cm (longer with perforator-based dissection) | Thicker adipose than radial forearm, varies by patient BMI and adipose distribution | Hemiglossectomy and total glossectomy defects, pharyngeal reconstruction, skull base reconstruction, external skin reconstruction | Versatile donor site utilized for many defects with low donor site morbidity, can harvest large surface area cutaneous paddle |
| Rectus | Musculocutaneous, can be perforator based | Deep inferior epigastric artery | 8 to 16 cm (longer with perforator-based dissection) | Often has thick adipose tissue | Total glossectomy defects, large-volume midface defects, skull base defects | If harvested as a perforator-based flap, has long pedicle. Often provides large volume of soft tissue in patients with low BMI. |
| Lateral arm | Fasciocutaneous | Posterior radial collateral artery | 6 to 8 cm | Intermediate thickness between radial forearm and anterolateral thigh | Parotid and external skin reconstruction, oral cavity defects | Excellent color match with neck and facial skin. Compartmentalized fat resists ptosis for external resurfacing. |
| Latissimus | Musculocutaneous | Thoracodorsal artery | 6 to 16 cm | May include a skin paddle or muscle only, subcutaneous tissue is often intermediate between anterolateral thigh and rectus donor sites | Scalp reconstruction, oral cavity defects | Large surface area of muscle can be harvested, ideal for large scalp defects |
| Medial sural artery perforator | Musculocutaneous | Medial sural artery | 8 to 13 cm | Thin, pliable, similar to radial forearm in most patients | Hemiglossectomy defects, external skin resurfacing | May be utilized in similar fashion as radial forearm flap in patients who have an abnormal Allen test or prefer not to use the forearm as donor site |
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