Venous Coupler Dopplers as Microvascular Free Flap Monitors

Objective The use of implantable Dopplers for microvascular free flap monitoring has been widely described as an efficient method for supervising flaps postoperatively. Recently a Doppler incorporated into the venous coupling device has been made available. This allows the use of a single apparatus. We report our experience with this device. Method This is a preliminary report of an ongoing prospective study of 19 microvascular free flaps mostly in the head and neck, completed from March 2010 to February 2011, where a venous coupled Doppler was used for postoperative monitoring. Results Nineteen free flaps are reported. Ten Dopplers (52.6%) maintained continuous positive signal throughout, 6 (31.6%) became position‐dependent and three (15.8%) became nonfunctional at some point. Two flaps required reoperation for flap and pedicle revision one day after surgery. The first, which developed a hematoma secondary to an arterial bleed from the vascular pedicle, maintained a positive Doppler signal. The second, which presented clinical evidence of impending flap failure, had an intermittent position‐dependent Doppler signal at the time of take back. Conclusion This study examines the efficacy of the venous coupled Doppler. Our preliminary results show positional variability in many patients. The venous Doppler coupler appears to be as effective in monitoring flaps postoperatively.