Palmar arch backflow following radial forearm free flap harvest

被引:19
|
作者
Kerawala, CJ
Martin, IC
机构
[1] Royal Surrey Cty Hosp, Dept Oral & Maxillofacial Surg, Guildford GU2 7XX, Surrey, England
[2] Sunderland Royal Hosp, Dept Oral & Facial Surg, Sunderland SR4 7TP, England
来源
BRITISH JOURNAL OF ORAL & MAXILLOFACIAL SURGERY | 2003年 / 41卷 / 03期
关键词
radial forearm free flap; segmental arterial pressure measurement; Allen test;
D O I
10.1016/S0266-4356(03)00023-8
中图分类号
R78 [口腔科学];
学科分类号
1003 ;
摘要
Background: Most surgeons advocate an Allen test (for occlusion of the radial or u1nar artery) and Doppler ultrasound examination before harvesting a forearm flap. In this study we attempted to correlate the results of these tests with intraoperative measurement of backflow pressure in the radial artery stump. Method: Stump pressures were measured in 30 patients after the flap had been harvested and were compared with preoperative assessment and intraloperative measurements of mean arterial pressure (MAP). Results: Mean arterial backflow pressure (MABP) in the arterial stump varied from 27 to 55 mmHg (mean 40.5). The ratio of this value to the mean arterial pressure ranged from 0.39 to 0.89 (mean 0.59) and exceeding 0.5 in 21 patients (70%). There was no correlation between this ratio and the preoperative assessment. Conclusions: These findings suggest that in the presence of a satisfactory Allen test and Doppler examination, there is adequate pressure in the palmar system to maintain vascular integrity of the donor hand after sacrifice of the radial artery. Despite the possibility of anatomical variants, the routine use of more invasive imaging is unnecessary. (C) 2003 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Science Ltd. All rights reserved.
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页码:157 / 160
页数:4
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