[The ulnar artery or the radial artery can be used alternatively in the free underarm flap].
BACKGROUND
The free, microvascular forearm flap is harvested and transplanted with the radial artery most frequently. Lovie and coworkers published the possibility to elevate this flap with the ulnar artery in 1984. Later on we introduced a DOPPLER-sonographic method to determine the artery which is dominant for the perfusion of the hand in order to leave this artery in the forearm. This procedure might minimize the donor site morbidity.


METHODS
In 9 years we treated 30 consecutive patients this way and interviewed them for dysaesthesia in contact with coldness. Furthermore we performed a standardized exposition to 17 degrees C cold water.


RESULTS
In 4 of 30 forearm flaps we had to experience flap necrosis. One patient suffered from dysaesthesia during extreme exposure to coldness (motorcycling during the winter without gloves). None of the patients showed dysaesthesia after one minute of cold water exposure.


CONCLUSIONS
Flap necrosis was relatively frequent in our patients but not related to the feeding vessel. On the other hand perfusion related donor site morbidity was extremely rare. To use the radial or the ulnar artery alternatively as the feeding vessel for transplantation of the forearm flap seems to be reasonable and keeps feared complications (disturbance of perfusion, cold-intolerance) rare.
Dost
P
P
Universitäts-Hals-Nasen-Ohren-Klinik Essen.
D000328:Adult; D000368:Aged; D003080:Cold Temperature / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D005542:Forearm / Q000098:blood supply / Q000601:surgery; D006225:Hand / Q000098:blood supply; D006801:Humans; D008297:Male; D008875:Middle Aged; D017534:Radial Artery / Q000000981:diagnostic imaging; D013524:Surgical Flaps; D013997:Time Factors; D017535:Ulnar Artery / Q000000981:diagnostic imaging; D018608:Ultrasonography, Doppler