The effect of radial artery reconstruction on the radial forearm donor site: a prospective study

Abstract

The purpose of this study was to evaluate the effect of radial artery reconstruction after radial forearm flap elevation and to study whether a vein graft can stay patent in this position. Ten consecutive oral cancer patients were included in the study. Pre-operative Allen's test was performed, and the flow velocity of both radial and ulnar arteries was recorded using colour Doppler ultrasonography. After flap elevation, the radial artery was reconstructed using the cephalic vein of the donor forearm as a free vein graft. The reconstructed artery was completely covered with surrounding skin, while the actual donor defect was covered with a split thickness skin graft. Colour Doppler ultrasonography was performed at 1–2 weeks and at 6–12 months post-operatively to record long-term patency. Radial artery reconstruction did not prolong the operations. All donor sites healed uneventfully. All of the reconstructed arteries were patent at the post-operative controls. In one patient, graft flow was missing on the first post-operative day but normal in the follow-up. A vein graft can remain patent with a very high success rate after radial artery reconstruction. A negative Allen’s test is not an absolute contraindication of a radial forearm flap as radial artery reconstruction can be performed.