Premium
PR24
POST OPERATIVE MONITORING IN 23 MICROVASCULAR FREE‐FLAP OPERATIONS UTILISING THE IMPLANTABLE DOPPLER FLOW SYSTEM
Author(s) -
James D. W.,
Langley S. J.
Publication year - 2009
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2009.04927_24.x
Subject(s) - medicine , free flap , surgery , doppler effect , free flap reconstruction , microsurgery , physics , astronomy
Purpose: The Cook‐Swartz Implantable Doppler has been used to provide continuous feedback on the vascular status of free flaps and has been reported to improve flap salvage. We review our experience of this device, its efficacy and suitability for ongoing use in free flap monitoring. Methodology: All patients who were monitored following free flap reconstruction using the Cook Swartz Implantable Doppler in two Hospitals in Christchurch, NZ were retrospectively reviewed from its first use in December 2006 to December 2008. Results: In total 43 probes were used on 23 flaps (4 buried, 7 intraoral) in 21 patients (range 17–83 yrs). The probes were placed on the artery in all cases and the vein in 21 cases. 21 (91.3%) flaps survived. 20 flaps had reliable Doppler signals. Overall there were 2 flap failures (8.7%) and these were not salvageable. There were no technical difficulties with application or removal of the probes and it was well received by junior medical/nursing staff. It provided peace of mind to surgeons performing free flap surgery outside the base hospital (6 cases). Conclusion: The implantable Doppler probe is a useful tool in monitoring free flaps where clinical evaluation is difficult especially when flaps are buried. Our current experience supports its ongoing use as a free flap monitoring tool at our institution.