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...
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creator | 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 |
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. |
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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.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm10153328</identifier><identifier>PMID: 34362111</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Clinical medicine ; Hospitals ; Medical imaging ; Microsurgery ; Oral cancer ; Ostomy ; Pulse oximetry ; Statistical analysis ; Surgery ; Ultrasonic imaging ; Veins & arteries</subject><ispartof>Journal of clinical medicine, 2021-07, Vol.10 (15), p.3328</ispartof><rights>2021 by the authors. 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/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 by the authors. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c367t-85ec3364beaeaa437577a6b49c737188e4a2054a4cc4254d359e58298dad4eed3</cites><orcidid>0000-0003-1483-2310 ; 0000-0003-3329-4896 ; 0000-0003-3284-6759 ; 0000-0001-9869-9240</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8347905/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8347905/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27923,27924,53790,53792</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34362111$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tousidonis, Manuel</creatorcontrib><creatorcontrib>Escobar, José Ignacio Salmerón</creatorcontrib><creatorcontrib>Caicoya, Santiago Ochandiano</creatorcontrib><creatorcontrib>Vila, Carlos Navarro</creatorcontrib><creatorcontrib>Cuéllar, Ignacio Navarro</creatorcontrib><creatorcontrib>Montiel, Alberto Díez</creatorcontrib><creatorcontrib>López, Ana María López</creatorcontrib><creatorcontrib>Cuéllar, Carlos Navarro</creatorcontrib><title>Preoperative Doppler Ultrasonography Allen Test for Radial Forearm Free Flap in Oral Cancer Reconstruction: Implications in Clinical Practice</title><title>Journal of clinical medicine</title><addtitle>J Clin Med</addtitle><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.</description><subject>Clinical medicine</subject><subject>Hospitals</subject><subject>Medical imaging</subject><subject>Microsurgery</subject><subject>Oral cancer</subject><subject>Ostomy</subject><subject>Pulse oximetry</subject><subject>Statistical analysis</subject><subject>Surgery</subject><subject>Ultrasonic imaging</subject><subject>Veins & arteries</subject><issn>2077-0383</issn><issn>2077-0383</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpdkVFLHDEQx5fSomJ98r0E-lIo1-5mkk22DwU5PSsIiujzMped0xzZZJvsCn6IfmezaOXaeZkZ5sefmfkXxXFVfgNoyu9b01dlJQG4flcc8FKpRQka3u_U-8VRStsyh9aCV2qv2AcBNa-q6qD4cx0pDBRxtI_ETsMwOIrszo0RU_DhPuLw8MROnCPPbimNbBMiu8HOomOrEAljz1aRiK0cDsx6dhXzZIneZJkbMsGnMU5mtMH_YBf94KzBuUkzu3TW596x64gZMfSx-LBBl-joNR8Wd6uz2-WvxeXV-cXy5HJhoFbjQksyALVYExKiACWVwnotGqNAVVqTQF5KgcIYwaXoQDYkNW90h50g6uCw-PmiO0zrnjpDPt_r2iHaHuNTG9C2_068fWjvw2OrQaimlFngy6tADL-n_Je2t8mQc-gpTKnlUjYCGg5NRj__h27DFH0-b6ZmSxpdZ-rrC2ViSCnS5m2Zqmxnp9sdpzP9aXf_N_avr_AMAw2mEg</recordid><startdate>20210728</startdate><enddate>20210728</enddate><creator>Tousidonis, Manuel</creator><creator>Escobar, José Ignacio Salmerón</creator><creator>Caicoya, Santiago Ochandiano</creator><creator>Vila, Carlos Navarro</creator><creator>Cuéllar, Ignacio Navarro</creator><creator>Montiel, Alberto Díez</creator><creator>López, Ana María López</creator><creator>Cuéllar, Carlos Navarro</creator><general>MDPI AG</general><general>MDPI</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-1483-2310</orcidid><orcidid>https://orcid.org/0000-0003-3329-4896</orcidid><orcidid>https://orcid.org/0000-0003-3284-6759</orcidid><orcidid>https://orcid.org/0000-0001-9869-9240</orcidid></search><sort><creationdate>20210728</creationdate><title>Preoperative Doppler Ultrasonography Allen Test for Radial Forearm Free Flap in Oral Cancer Reconstruction: Implications in Clinical Practice</title><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></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c367t-85ec3364beaeaa437577a6b49c737188e4a2054a4cc4254d359e58298dad4eed3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Clinical medicine</topic><topic>Hospitals</topic><topic>Medical imaging</topic><topic>Microsurgery</topic><topic>Oral cancer</topic><topic>Ostomy</topic><topic>Pulse oximetry</topic><topic>Statistical analysis</topic><topic>Surgery</topic><topic>Ultrasonic imaging</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tousidonis, Manuel</creatorcontrib><creatorcontrib>Escobar, José Ignacio Salmerón</creatorcontrib><creatorcontrib>Caicoya, Santiago Ochandiano</creatorcontrib><creatorcontrib>Vila, Carlos Navarro</creatorcontrib><creatorcontrib>Cuéllar, Ignacio Navarro</creatorcontrib><creatorcontrib>Montiel, Alberto Díez</creatorcontrib><creatorcontrib>López, Ana María López</creatorcontrib><creatorcontrib>Cuéllar, Carlos Navarro</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of clinical medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tousidonis, Manuel</au><au>Escobar, José Ignacio Salmerón</au><au>Caicoya, Santiago Ochandiano</au><au>Vila, Carlos Navarro</au><au>Cuéllar, Ignacio Navarro</au><au>Montiel, Alberto Díez</au><au>López, Ana María López</au><au>Cuéllar, Carlos Navarro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preoperative Doppler Ultrasonography Allen Test for Radial Forearm Free Flap in Oral Cancer Reconstruction: Implications in Clinical Practice</atitle><jtitle>Journal of clinical medicine</jtitle><addtitle>J Clin Med</addtitle><date>2021-07-28</date><risdate>2021</risdate><volume>10</volume><issue>15</issue><spage>3328</spage><pages>3328-</pages><issn>2077-0383</issn><eissn>2077-0383</eissn><abstract>The Radial Forearm Free Flap (RFFF) is one of the most widely used microsurgical flaps for intraoral reconstruction. 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subjects | Clinical medicine Hospitals Medical imaging Microsurgery Oral cancer Ostomy Pulse oximetry Statistical analysis Surgery Ultrasonic imaging Veins & arteries |
title | Preoperative Doppler Ultrasonography Allen Test for Radial Forearm Free Flap in Oral Cancer Reconstruction: Implications in Clinical Practice |
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