دورية أكاديمية
Preoperative Examination Is Not Associated with Postoperative Function following Radial Forearm Free Flap Harvest.
العنوان: | Preoperative Examination Is Not Associated with Postoperative Function following Radial Forearm Free Flap Harvest. |
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المؤلفون: | Emanuelli E; From the Departments of Plastic Surgery., Egan KG; From the Departments of Plastic Surgery., Bins G; From the Departments of Plastic Surgery., Nazir N; Population Health., Bur AM; Otolaryngology, University of Kansas Medical Center., Kakarala K; Otolaryngology, University of Kansas Medical Center., Przylecki W; From the Departments of Plastic Surgery., Endress R; From the Departments of Plastic Surgery. |
المصدر: | Plastic and reconstructive surgery [Plast Reconstr Surg] 2023 May 01; Vol. 151 (5), pp. 828e-837e. Date of Electronic Publication: 2022 Dec 21. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 1306050 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1529-4242 (Electronic) Linking ISSN: 00321052 NLM ISO Abbreviation: Plast Reconstr Surg Subsets: MEDLINE |
أسماء مطبوعة: | Publication: Original Publication: Baltimore : Williams & Wilkins, |
مواضيع طبية MeSH: | Free Tissue Flaps* , Plastic Surgery Procedures*/adverse effects, Humans ; Retrospective Studies ; Tissue Donors ; Hand |
مستخلص: | Background: There is debate on the utility of a preoperative Allen test or ultrasound before radial forearm free flap (RFFF) harvest. This study sought to evaluate correlations between preoperative testing and donor-site morbidity. Methods: A survey of plastic surgery and otolaryngology RFFF patients was conducted at a Midwestern academic center. The modified Cold Intolerance Symptom Severity (modCISS) and Quick Disabilities of the Arm, Shoulder, and Hand (QDASH) instruments were administered. A retrospective chart review was performed to assess perioperative factors. Results: Of 212 RFFFs completed over 7 years, 144 patients were contacted, and 71 patients completed the survey (33% response rate). Preoperative Allen test was negative in 92% of patients (65 of 71). There was no statistical association between Allen test and duplex ultrasound findings ( P = 0.19). Cold intolerance screening was positive on 20% of donor arms (14 of 71), with an average positive modCISS score of 39.0 ± 14.7. Disability was reported on the QDASH by 76% of patients (54 of 71), with an average score of 21.0 ± 22.3. There was no statistical correlation between preoperative Allen test or ultrasound classification and modCISS or QDASH score. There was a borderline positive correlation between modCISS and QDASH scores that did not reach statistical significance ( r = 0.22, P = 0.067). Operative characteristics also did not predict modCISS or QDASH scores. Conclusions: Following RFFF harvest, donor extremity cold intolerance is reported in 20% of patients, and extremity-related disability is reported in the majority of patients. Preoperative ultrasound and physical examination findings are not predictive of morbidity. (Copyright © 2022 by the American Society of Plastic Surgeons.) |
References: | Chen H, Zhou N, Huang X, Song S. Comparison of morbidity after reconstruction of tongue defects with an anterolateral thigh cutaneous flap compared with a radial forearm free-flap: a meta-analysis. Br J Oral Maxillofac Surg. 2016;54:1095–1101. Ganesan K, Stead L, Smith AB, Ong TK, Mitchell DA, Kanatas AN. Duplex in the assessment of the free radial forearm flaps: is it time to change practice? Br J Oral Maxillofac Surg. 2010;48:423–426. Lutz BS, Wei FC, Chang SC, Yang KH, Chen IH. Donor site morbidity after suprafascial elevation of the radial forearm flap: a prospective study in 95 consecutive cases. Plast Reconstr Surg. 1999;103:132–137. Meland NB, Core GB, Hoverman VR. The radial forearm flap donor site: should we vein graft the artery? A comparative study. Plast Reconstr Surg. 1993;91:865–870; discussion 871. de Bree R, Hartley C, Smeele LE, Kuik DJ, Quak JJ, Leemans CR. Evaluation of donor site function and morbidity of the fasciocutaneous radial forearm flap. Laryngoscope. 2004;114:1973–1976. Richardson D, Fisher SE, Vaughan ED, Brown JS. Radial forearm flap donor-site complications and morbidity: a prospective study. Plast Reconstr Surg. 1997;99:109–115. Suominen S, Ahovuo J, Asko-Seljavaara S. Donor site morbidity of radial forearm flaps. A clinical and ultrasonographic evaluation. Scand J Plast Reconstr Surg Hand Surg. 1996;30:57–61. Van Caenegem E, Verhaeghe E, Taes Y, et al. Long-term evaluation of donor-site morbidity after radial forearm flap phalloplasty for transsexual men. J Sex Med. 2013;10:1644–1651. Abdullakutty A, Bajwa MS, Patel S, D’Souza J. Clinical audit and national survey on the assessment of collateral circulation before radial forearm free flap harvest. J Craniomaxillofac Surg. 2017;45:108–112. Muller-Richter UD, Driemel O, Mortl M, et al. The value of Allen’s test in harvesting a radial forearm flap: correlation of ex-vivo angiography and histopathological findings. Int J Oral Maxillofac Surg. 2008;37:672–674. Lannau B, Bliley J, James IB, et al. Long-term patency of primary arterial repair and the modified Cold Intolerance Symptom Severity questionnaire. Plast Reconstr Surg Glob Open. 2015;3:e551. Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap): a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42:377–381. Nuckols DA, Tsue TT, Toby EB, Girod DA. Preoperative evaluation of the radial forearm free flap patient with the objective Allen’s test. Otolaryngol Head Neck Surg. 2000;123:553–557. Wood JW, Broussard KC, Burkey B. Preoperative testing for radial forearm free flaps to reduce donor site morbidity. JAMA Otolaryngol Head Neck Surg. 2013;139:183–186. Ciria-Llorens G, Gomez-Cia T, Talegon-Melendez A. Analysis of flow changes in forearm arteries after raising the radial forearm flap: a prospective study using colour duplex imaging. Br J Plast Surg. 1999;52:440–444. Ruijs AC, Jaquet JB, Daanen HA, Hovius SE. Cold intolerance of the hand measured by the CISS questionnaire in a normative study population. J Hand Surg Br. 2006;31:533–536. Carlsson IK, Rosen B, Dahlin LB. Self-reported cold sensitivity in normal subjects and in patients with traumatic hand injuries or hand-arm vibration syndrome. BMC Musculoskelet Disord. 2010;11:89. Kiehn M, Brooks D, Lee C, Kind G, Buntic R, Buncke G. Patency of radial arteries reconstructed after radial forearm flap harvest. J Reconstr Microsurg. 2007;23:347–349. Bertino G, Lepenne Y, Tinelli C, et al. Radial vs ulnar forearm flap: a preliminary study of donor site morbidity. Acta Otorhinolaryngol Ital. 2019;39:322–328. Fang QG, Shi S, Zhang X, Li ZN, Liu FY, Sun CF. Upper extremity morbidity after radial forearm flap harvest: a prospective study. J Int Med Res. 2014;42:231–235. Sinclair CF, Gleysteen JP, Zimmermann TM, et al. Assessment of donor site morbidity for free radial forearm osteocutaneous flaps. Microsurgery. 2012;32:255–260. Riecke B, Kohlmeier C, Assaf AT, et al. Prospective biomechanical evaluation of donor site morbidity after radial forearm free flap. Br J Oral Maxillofac Surg. 2016;54:181–186. Jester A, Harth A, Germann G. Measuring levels of upper-extremity disability in employed adults using the DASH questionnaire. J Hand Surg Am. 2005;30:1074.e1–1074.e10. Aasheim T, Finsen V. The DASH and the QuickDASH instruments. Normative values in the general population in Norway. J Hand Surg Eur Vol. 2014;39:140–144. Hunsaker FG, Cioffi DA, Amadio PC, Wright JG, Caughlin B. The American Academy of Orthopaedic Surgeons outcomes instruments: normative values from the general population. J Bone Joint Surg Am. 2002;84:208–215. Brown MT, Couch ME, Huchton DM. Assessment of donor-site functional morbidity from radial forearm fasciocutaneous free flap harvest. Arch Otolaryngol Head Neck Surg. 1999;125:1371–1374. Orlik JR, Horwich P, Bartlett C, Trites J, Hart R, Taylor SM. Long-term functional donor site morbidity of the free radial forearm flap in head and neck cancer survivors. J Otolaryngol Head Neck Surg. 2014;43:1. Chang EI, Liu J. Prospective comparison of donor site morbidity following radial forearm and ulnar artery perforator flap harvest. Plast Reconstr Surg. 2020;145:1267–1274. Patsalis T, Hoffmeister HE, Seboldt H. Arterial dominance of the hand (in German). Handchir Mikrochir Plast Chir. 1997;29:247–250. Dumanian GA, Segalman K, Mispireta LA, Walsh JA, Hendrickson MF, Wilgis EF. Radial artery use in bypass grafting does not change digital blood flow or hand function. Ann Thorac Surg. 1998;65:1284–1287. |
تواريخ الأحداث: | Date Created: 20230202 Date Completed: 20230517 Latest Revision: 20230727 |
رمز التحديث: | 20231215 |
DOI: | 10.1097/PRS.0000000000010089 |
PMID: | 36729071 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1529-4242 |
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DOI: | 10.1097/PRS.0000000000010089 |