Predictive value of the milking patency test when performing the arterial microanastomosis in head and neck surgery.
free flap
microsurgery
milking patency test
Journal
Head & neck
ISSN: 1097-0347
Titre abrégé: Head Neck
Pays: United States
ID NLM: 8902541
Informations de publication
Date de publication:
09 2019
09 2019
Historique:
received:
20
03
2019
revised:
10
04
2019
accepted:
04
06
2019
pubmed:
23
6
2019
medline:
19
12
2020
entrez:
23
6
2019
Statut:
ppublish
Résumé
The milking patency test (MPT) is widely used to assess the patency of microanastomosis, despite it being proven to be a traumatic test. We performed microanastomoses with intentional two-wall stitches and asked senior microsurgeons to evaluate the permeability of the anastomoses by looking first at the results of the MPT, then according to artery pulsation. Microsurgeons were all accurate in evaluating normal or clamped anastomoses. But in anastomoses with defects, the MPT was considered normal 94%, 85%, and 73%. MPT has a positive predictive value of 100% but with a negative predictive value of 27.5%. Observation of the artery pulsation distal to the anastomosis gave similar results. Our experiment shows that the two-wall stitches on arterial anastomoses are hardly detected by an MPT. The observed pulsation of the artery gives the same results and could be used instead, without damaging the vessels.
Sections du résumé
BACKGROUND
The milking patency test (MPT) is widely used to assess the patency of microanastomosis, despite it being proven to be a traumatic test.
METHODS
We performed microanastomoses with intentional two-wall stitches and asked senior microsurgeons to evaluate the permeability of the anastomoses by looking first at the results of the MPT, then according to artery pulsation.
RESULTS
Microsurgeons were all accurate in evaluating normal or clamped anastomoses. But in anastomoses with defects, the MPT was considered normal 94%, 85%, and 73%. MPT has a positive predictive value of 100% but with a negative predictive value of 27.5%. Observation of the artery pulsation distal to the anastomosis gave similar results.
CONCLUSIONS
Our experiment shows that the two-wall stitches on arterial anastomoses are hardly detected by an MPT. The observed pulsation of the artery gives the same results and could be used instead, without damaging the vessels.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3328-3333Informations de copyright
© 2019 Wiley Periodicals, Inc.