Ischaemia of the hand after harvest of a radial forearm flap.
The development of ischaemia in the hand after harvest of a radial forearm flap is extremely rare. Previous cases have been caused by anatomical anomalies or conditions that may have been detectable by ultrasonography. We report the development of ischaemia after harvest of a radial forearm flap despite a normal preoperative Allen's test and a normal Doppler ultrasound scan, in a non-smoker with no evidence of peripheral vascular disease. Angiographic appearances suggested that the ischaemia may have been secondary to an incomplete superficial palmar arch. This case highlights the potential for development of ischaemia despite normal preoperative investigations, with obvious ramifications for obtaining consent.
Varley
Iain
I
Department of Oral & Maxillofacial Surgery, York Hospital, Wigginton Road, York YO31 8HE, United Kingdom. iainvarley@gmail.com
Carter
Lachlan M
LM
Wales
Craig J
CJ
Warnock
Niall
N
Whitfield
Paul H
PH
D002294:Carcinoma, Squamous Cell / Q000601:surgery; D005542:Forearm / Q000601:surgery; D006225:Hand / Q000098:blood supply* / Q000000981:diagnostic imaging; D006801:Humans; D054061:Ischemic Contracture / Q000209:etiology*; D008297:Male; D008339:Mandibular Neoplasms / Q000601:surgery; D008875:Middle Aged; D017534:Radial Artery / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply; D020858:Tissue and Organ Harvesting / Q000009:adverse effects*; D014463:Ultrasonography