Document Detail

Palmar arch backflow following radial forearm free flap harvest.
MedLine Citation:
PMID:  12804539     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Most surgeons advocate an Allen test (for occlusion of the radial or ulnar 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 intraoperative measurements of mean arterial pressure (MAP). RESULTS: Mean arterial backflow pressure (MABP) in the arterial stump varied from 27 to 55mm Hg (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 J Kerawala; I C Martin
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The British journal of oral & maxillofacial surgery     Volume:  41     ISSN:  0266-4356     ISO Abbreviation:  Br J Oral Maxillofac Surg     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-06-13     Completed Date:  2003-10-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8405235     Medline TA:  Br J Oral Maxillofac Surg     Country:  Scotland    
Other Details:
Languages:  eng     Pagination:  157-60     Citation Subset:  D; IM    
Department of Oral and Maxillofacial Surgery, Royal Surrey County Hospital, Egerton Road, Surrey GU2 7XX, Guildford, UK.
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MeSH Terms
Aged, 80 and over
Blood Pressure / physiology
Forearm / blood supply
Hand / blood supply*
Intraoperative Care
Middle Aged
Preoperative Care
Radial Artery / transplantation*,  ultrasonography
Regional Blood Flow / physiology
Surgical Flaps*
Ulnar Artery / physiology,  ultrasonography
Ultrasonography, Doppler

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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