Cargando…

Preoperative Doppler Ultrasonography Allen Test for Radial Forearm Free Flap in Oral Cancer Reconstruction: Implications in Clinical Practice

The Radial Forearm Free Flap (RFFF) is one of the most widely used microsurgical flaps for intraoral reconstruction. Although the Clinical Allen Test (CAT) is the most widely used preoperative diagnostic method with which to study the distal patency of the hand prior to the use of RFFF, several auth...

Descripción completa

Detalles Bibliográficos
Autores principales: Tousidonis, Manuel, Escobar, José Ignacio Salmerón, Caicoya, Santiago Ochandiano, Vila, Carlos Navarro, Cuéllar, Ignacio Navarro, Montiel, Alberto Díez, López, Ana María López, Cuéllar, Carlos Navarro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8347905/
https://www.ncbi.nlm.nih.gov/pubmed/34362111
http://dx.doi.org/10.3390/jcm10153328
_version_ 1783735207716716544
author Tousidonis, Manuel
Escobar, José Ignacio Salmerón
Caicoya, Santiago Ochandiano
Vila, Carlos Navarro
Cuéllar, Ignacio Navarro
Montiel, Alberto Díez
López, Ana María López
Cuéllar, Carlos Navarro
author_facet Tousidonis, Manuel
Escobar, José Ignacio Salmerón
Caicoya, Santiago Ochandiano
Vila, Carlos Navarro
Cuéllar, Ignacio Navarro
Montiel, Alberto Díez
López, Ana María López
Cuéllar, Carlos Navarro
author_sort Tousidonis, Manuel
collection PubMed
description The Radial Forearm Free Flap (RFFF) is one of the most widely used microsurgical flaps for intraoral reconstruction. Although the Clinical Allen Test (CAT) is the most widely used preoperative diagnostic method with which to study the distal patency of the hand prior to the use of RFFF, several authors have reported potentially preventable serious vascular complications. This study included 87 consecutive patients with cancer of the oral cavity and RFFF as the flap of choice who were treated between 2010 and 2020, and compares the results of the Clinical Allen Test (CAT), the Doppler Allen Test (DAT) and the Surgical Allen Test (SAT). The preoperative vascular study found vascular abnormalities severe enough for the surgical team to change the preoperative flap of choice in 39% of patients. The Kappa index showed a weak concordance between the CAT and DAT. The study reflected a total concordance in the preoperative results of the Doppler study and the intraoperative results of the SAT. Due to its excellent agreement with SAT, the DAT would be the preoperative test of choice in patients who are candidates for RFFF. This study of vascular mapping tests with Doppler is intended to inform therapeutic decisions and present methods to gain information that cannot be obtained by physical examination alone.
format Online
Article
Text
id pubmed-8347905
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-83479052021-08-08 Preoperative Doppler Ultrasonography Allen Test for Radial Forearm Free Flap in Oral Cancer Reconstruction: Implications in Clinical Practice Tousidonis, Manuel Escobar, José Ignacio Salmerón Caicoya, Santiago Ochandiano Vila, Carlos Navarro Cuéllar, Ignacio Navarro Montiel, Alberto Díez López, Ana María López Cuéllar, Carlos Navarro J Clin Med Article The Radial Forearm Free Flap (RFFF) is one of the most widely used microsurgical flaps for intraoral reconstruction. Although the Clinical Allen Test (CAT) is the most widely used preoperative diagnostic method with which to study the distal patency of the hand prior to the use of RFFF, several authors have reported potentially preventable serious vascular complications. This study included 87 consecutive patients with cancer of the oral cavity and RFFF as the flap of choice who were treated between 2010 and 2020, and compares the results of the Clinical Allen Test (CAT), the Doppler Allen Test (DAT) and the Surgical Allen Test (SAT). The preoperative vascular study found vascular abnormalities severe enough for the surgical team to change the preoperative flap of choice in 39% of patients. The Kappa index showed a weak concordance between the CAT and DAT. The study reflected a total concordance in the preoperative results of the Doppler study and the intraoperative results of the SAT. Due to its excellent agreement with SAT, the DAT would be the preoperative test of choice in patients who are candidates for RFFF. This study of vascular mapping tests with Doppler is intended to inform therapeutic decisions and present methods to gain information that cannot be obtained by physical examination alone. MDPI 2021-07-28 /pmc/articles/PMC8347905/ /pubmed/34362111 http://dx.doi.org/10.3390/jcm10153328 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Tousidonis, Manuel
Escobar, José Ignacio Salmerón
Caicoya, Santiago Ochandiano
Vila, Carlos Navarro
Cuéllar, Ignacio Navarro
Montiel, Alberto Díez
López, Ana María López
Cuéllar, Carlos Navarro
Preoperative Doppler Ultrasonography Allen Test for Radial Forearm Free Flap in Oral Cancer Reconstruction: Implications in Clinical Practice
title Preoperative Doppler Ultrasonography Allen Test for Radial Forearm Free Flap in Oral Cancer Reconstruction: Implications in Clinical Practice
title_full Preoperative Doppler Ultrasonography Allen Test for Radial Forearm Free Flap in Oral Cancer Reconstruction: Implications in Clinical Practice
title_fullStr Preoperative Doppler Ultrasonography Allen Test for Radial Forearm Free Flap in Oral Cancer Reconstruction: Implications in Clinical Practice
title_full_unstemmed Preoperative Doppler Ultrasonography Allen Test for Radial Forearm Free Flap in Oral Cancer Reconstruction: Implications in Clinical Practice
title_short Preoperative Doppler Ultrasonography Allen Test for Radial Forearm Free Flap in Oral Cancer Reconstruction: Implications in Clinical Practice
title_sort preoperative doppler ultrasonography allen test for radial forearm free flap in oral cancer reconstruction: implications in clinical practice
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8347905/
https://www.ncbi.nlm.nih.gov/pubmed/34362111
http://dx.doi.org/10.3390/jcm10153328
work_keys_str_mv AT tousidonismanuel preoperativedopplerultrasonographyallentestforradialforearmfreeflapinoralcancerreconstructionimplicationsinclinicalpractice
AT escobarjoseignaciosalmeron preoperativedopplerultrasonographyallentestforradialforearmfreeflapinoralcancerreconstructionimplicationsinclinicalpractice
AT caicoyasantiagoochandiano preoperativedopplerultrasonographyallentestforradialforearmfreeflapinoralcancerreconstructionimplicationsinclinicalpractice
AT vilacarlosnavarro preoperativedopplerultrasonographyallentestforradialforearmfreeflapinoralcancerreconstructionimplicationsinclinicalpractice
AT cuellarignacionavarro preoperativedopplerultrasonographyallentestforradialforearmfreeflapinoralcancerreconstructionimplicationsinclinicalpractice
AT montielalbertodiez preoperativedopplerultrasonographyallentestforradialforearmfreeflapinoralcancerreconstructionimplicationsinclinicalpractice
AT lopezanamarialopez preoperativedopplerultrasonographyallentestforradialforearmfreeflapinoralcancerreconstructionimplicationsinclinicalpractice
AT cuellarcarlosnavarro preoperativedopplerultrasonographyallentestforradialforearmfreeflapinoralcancerreconstructionimplicationsinclinicalpractice