Preoperative vascular assessment of the lower limb for harvest of a fibular flap: the views of vascular surgeons in the United Kingdom

The British Journal of Oral & Maxillofacial Surgery
S P WhitleyA Cardozo

Abstract

Adequate preoperative vascular assessment of the lower limb is essential before harvesting fibular free flaps to prevent ischaemic complications or failure of the flap. The best method of assessment remains controversial. Clinical examination, conventional angiography, colour flow Doppler, and magnetic resonance angiography have all been advocated. We asked 206 UK vascular surgeons for their opinions on preoperative assessment and potential issues of negligence and 85 (42%) completed the questionnaire. All respondents thought that further imaging should be done in addition to clinical examination, most of whom (n = 70) favoured colour flow Doppler (82%). In addition 75 (88%) considered that the surgeon would be judged to be negligent if clinical examination was the only preoperative assessment. In the light of these findings, we suggest that an objective assessment of the vasculature of the leg should be obtained before a fibular flap is harvested.

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Citations

Jun 7, 2005·The British Journal of Oral & Maxillofacial Surgery·M C BaterE Tilley
Nov 15, 2011·Journal of Cranio-maxillo-facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery·W H WangB Xu
Mar 15, 2011·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·Klaus D WolffMarco R Kesting
Jan 18, 2006·Journal of Vascular and Interventional Radiology : JVIR·Dominik FleischmannGeoffrey D Rubin
Nov 21, 2009·The British Journal of Oral & Maxillofacial Surgery·Craig J WalesJeremy McMahon
Jan 8, 2014·Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology·Alireza GhassemiLloyd Nanhekhan
Oct 7, 2006·The British Journal of Oral & Maxillofacial Surgery·Rajiv AnandPeter A Brennan
Mar 13, 2016·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Ruimei SunZhaoming Zhong
May 23, 2017·Journal of Stomatology, Oral and Maxillofacial Surgery·R GryseleynJ Ferri
Jan 4, 2017·The Journal of Craniofacial Surgery·Yigit Ozer TiftikciogluTahir Gurler
Jan 6, 2010·Plastic and Reconstructive Surgery·Christopher Glenn WallaceFu-Chan Wei
Feb 8, 2006·Plastic and Reconstructive Surgery·Samir MardiniPaolo Sassu

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