Hemodynamics in hand following elevation of a radial forearm flap

概要

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Radial forearm flaps are often used for reconstruction in head and neck surgery. The Allen's test must be performed prior to creation of forearm flap to assess collateral circulation supplying the hand through the ulnar artery and the palmar arches. It is generally accepted that if the results is normal, the hand will be free from vascular complications. We measured blood pressure at both index fingers of 22 patiants (from one day to five years and seven months after operation), to evaluate changes in blood flow that is caused by resection of the radial artery. All the patients showed normal Allen's test before operation. In the flap side hand, blood pressure was significantly less than that in another hand. The decreasing rate of mean blood pressure (MBP) : (contralateral side MBP-flap side MBP) / healthy side MBP, was averaging 6.9%. Althogh the rate was more than 20% in a case right after operation, it gradually became better after operation. In the earlier group (less than 60 days after operation), the rate was significantly higher. However all cases had no symptom of vascular complications, such decrease of blood pressure suggested allowable change for circulation of the hand after resection of the radial artery.
特定非営利活動法人日本頭頸部外科学会の論文