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Preoperative Examination Is Not Associated with Postoperative Function following Radial Forearm Free Flap Harvest.
- Source :
-
Plastic and reconstructive surgery [Plast Reconstr Surg] 2023 May 01; Vol. 151 (5), pp. 828e-837e. Date of Electronic Publication: 2022 Dec 21. - Publication Year :
- 2023
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Abstract
- 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.<br />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.<br />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.<br />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.<br /> (Copyright © 2022 by the American Society of Plastic Surgeons.)
Details
- Language :
- English
- ISSN :
- 1529-4242
- Volume :
- 151
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Plastic and reconstructive surgery
- Publication Type :
- Academic Journal
- Accession number :
- 36729071
- Full Text :
- https://doi.org/10.1097/PRS.0000000000010089