Reversible ischaemia after raising a radial forearm flap with ulceration of three fingers in a cigarette smoker.
The radial forearm flap is a standard method for the reconstruction of intraoral defects of soft tissues. We report the case of a middle-aged man who developed ischaemia in three fingers after a fasciocutaneous radial flap had been raised. The preoperative Allen test to diagnose occlusion of radial or ulnar artery was satisfactory. Soon after the operation the patient resumed smoking and four weeks later he developed ulcers on the thumb, index, and middle fingers. Only after he had stopped smoking and been given acetylsalicylic acid and heparin did blood flow and capillary hemoglobin oxygenation increase. As a result, his radial fingers recovered completely.
Hölzle
F
F
Department of Oral and Maxillofacial Surgery, Ruhr University of Bochum, Knappschaftskrankenhaus Bochum-Langendreer, In der Schornau 23-25, 44892 Bochum, Germany. frank.hoelzle@ruhr-uni-bochum-de
Kesting
M R
MR
Nolte
D
D
Loeffelbein
D J
DJ
Swaid
S
S
Wolff
K D
KD
D000925:Anticoagulants / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D005205:Fascia / Q000637:transplantation*; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005385:Fingers / Q000098:blood supply*; D005542:Forearm / Q000098:blood supply / Q000601:surgery; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007511:Ischemia / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery; D009336:Necrosis; D011183:Postoperative Complications; D017534:Radial Artery / Q000503:physiopathology; D012039:Regional Blood Flow / Q000502:physiology; D016038:Skin Transplantation; D012883:Skin Ulcer / Q000209:etiology*; D012907:Smoking / Q000009:adverse effects*; D013524:Surgical Flaps; D013933:Thumb / Q000098:blood supply; D017535:Ulnar Artery / Q000503:physiopathology
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D006493:Heparin; D001241:Aspirin