The British journal of oral & maxillofacial surgery
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Br J Oral Maxillofac Surg · Sep 2010
Patency of the radial artery following intra-luminal cannulation and its influence on potential flap harvest for head and neck reconstruction.
The radial forearm free flap (RFFF) is well-established in head and neck reconstruction, but early potential failure may necessitate a contingency plan, which could include the opposite RFFF if cannulation of the relevant artery at the time of the first operation did not influence its patency. We prospectively studied patients listed for major operations who required radial artery cannulation. They all had perioperative imaging of the radial artery with colour flow duplex before cannulation and at intervals after the cannula had been removed (2h-7 days). ⋯ Thirty-three had patent vessels within 2h of the cannula being removed, and 39/40 at 24h. Patency after removal of the cannula returns rapidly, and is almost always complete by 24h. In most people the contralateral radial forearm could therefore be used to mode of salvage reconstruction if the flap failed early.
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Br J Oral Maxillofac Surg · Apr 2010
Optimisation of intraoperative haemodynamics: early experience of its use in major head and neck surgery.
The risk of complications and duration of hospital stay can both be reduced by the use of a monitoring protocol to maximise haemodynamic flow during operation in patients having major abdominal and orthopaedic operations. We describe using a protocol for intraoperative fluid management and our early experience with it in patients having major head and neck surgery.