Preoperative evaluation of the radial forearm free flap patient with the objective Allen's test.
OBJECTIVE
The conventional subjective Allen's test (SAT) can be problematic because of its subjective nature. The objective Allen's test (OAT) was used before surgery to reliably and objectively assess forearm vascular flow in anticipation of harvesting a radial forearm free flap (RFFF) for use in head and neck reconstruction.


METHODS
Retrospective analysis of 65 patients undergoing both preoperative SAT and OAT was completed at the University of Kansas Medical Center between December 1994 and March 1998.


RESULTS
The sensitivity and specificity of the SAT compared with the sensitivity and specificity of the OAT were only 65% and 76%, respectively. In 40 patients with at least 1 forearm with a positive SAT, only 1 (2.5%) patient was found by OAT to have vasculature that would not have allowed safe RFFF harvest in either forearm. In contrast, of the 25 patients with equivocal or negative SAT results in both arms, 18 (72%) were found by OAT to be safe candidates for RFFF harvests.


CONCLUSIONS
The OAT is an objective measure of forearm vascular flow and is superior to conventional SAT in RFFF donor-site selection.
Nuckols
D A
DA
Department of Otolaryngology-Head and Neck Surgery, University of Kansas School of Medicine, Kansas City, Kansas 66160, USA.
Tsue
T T
TT
Toby
E B
EB
Girod
D A
DA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005542:Forearm / Q000098:blood supply*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010991:Plethysmography; D012039:Regional Blood Flow; D012680:Sensitivity and Specificity; D013524:Surgical Flaps / Q000098:blood supply*