• Br J Oral Maxillofac Surg · Aug 2004

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

    • S P Whitley, S Sandhu, and A Cardozo.
    • Department of Oral and Maxillofacial Surgery, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK. spwhitley@btinternet.com
    • Br J Oral Maxillofac Surg. 2004 Aug 1;42(4):307-10.

    AbstractAdequate 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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