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Preoperative Examination Is Not Associated with Postoperative Function following Radial Forearm Free Flap Harvest
Elisa Emanuelli1, Katie G Egan1, Griffin Bins1
1From the Departments of Plastic Surgery.
Plastic and Reconstructive Surgery
|February 2, 2023
Summary
Preoperative tests like the Allen test and ultrasound do not predict arm complications after radial forearm free flap (RFFF) surgery. Many patients experience cold intolerance or disability, regardless of these preoperative assessments.
Area of Science:
- Plastic Surgery
- Otolaryngology
- Microsurgery
Background:
- Debate exists regarding the utility of preoperative Allen test or ultrasound before radial forearm free flap (RFFF) harvest.
- This study aimed to assess the correlation between preoperative testing and donor-site morbidity.
Purpose of the Study:
- To evaluate the predictive value of preoperative Allen test and duplex ultrasound for donor-site morbidity after RFFF harvest.
- To determine the incidence of cold intolerance and disability following RFFF harvest.
Main Methods:
- A survey of plastic surgery and otolaryngology patients who underwent RFFF harvest was conducted.
- Modified Cold Intolerance Symptom Severity (modCISS) and Quick Disabilities of the Arm, Shoulder, and Hand (QDASH) instruments were used.
- A retrospective chart review assessed perioperative factors.
Main Results:
- Of 71 surveyed patients, 92% had a negative preoperative Allen test.
- No statistical association was found between Allen test or ultrasound findings and cold intolerance (modCISS) or disability (QDASH) scores.
- 20% of patients reported cold intolerance, and 76% reported some degree of arm disability.
Conclusions:
- Donor extremity cold intolerance and disability are common following RFFF harvest.
- Preoperative Allen test and ultrasound findings do not reliably predict postoperative donor-site morbidity.
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