The value of Allen's test in harvesting a radial forearm flap: correlation of ex-vivo angiography and histopathological findings.

The radial forearm flap is one of the most commonly raised free flaps. In most cases an Allen's test is sufficient for preoperative assessment of the palmar arch, but an intact palmar arch does not imply that the radial artery is suitable for microvascular anastomosis. For a patient operated for oral squamous cell carcinoma, reconstruction was planned with a radial forearm flap. The flap had to be discarded because of advanced atherosclerosis in the presence of a negative Allen's test. The correlation of an ex-vivo angiography and the histopathologic findings was assessed. In cases of expected vascular disease, further examinations like color flow Doppler ultrasound are recommended to ensure sufficient perfusion of the radial artery.