The flap can be bulky in obese individuals. Although the vascular anatomy is fairly constant, in less than 2% of cases, an anomalous dual arterial supply from the profunda brachii artery can occur. These arteries may be smaller than usual. Even with normal arterial anatomy, the artery is small, measuring between 1 and 2 mm; however, this shortcoming can be overcome by dissecting the vascular pedicle to the brachial artery and vein. The donor veins are usually much larger: between 2 and 3 mm. ^ Postoperative anesthesia of the upper lateral forearm is to be expected.
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