Postoperative monitoring of free flap reconstruction: A comparison of external Doppler ultrasonography and the implantable Doppler probe

Rayaad C. Hosein, Agustin Cornejo, Howard T. Wang

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

HYPOTHESIS: The time to detection of vascular compromise and the postoperative time to re-exploration are shorter using the implantable Doppler (ID) probe, thereby resulting in earlier surgical re-exploration and a higher flap salvage rate. METHODS: A single-centre experience with 176 consecutive free flap reconstructions in 167 patients from 2000 to 2008 in a university-based teaching hospital by retrospective chart review is presented. RESULTS: There was a significant difference in overall flap survival (ID 98.0%, external Doppler [ED] 89.3%) and total flap loss (ID 2.0%, ED 10.7%) between the two groups (P=0.03).The difference in flap salvage rate was not significant (ID 90.9%, ED 63.6%; P=0.068). The false-positive (ID 0%, ED 3%; P=0.18) and false-negative rates (ID 0.0%, ED 4.5%; P=1.0) were not significantly different. There was also a lower median postoperative time to re-exploration for the ID group, from 48 h to one week after initial surgery (ID 74.5 h, ED 136.8 h; P=0.05). CONCLUSION: The present analysis revealed a potential benefit for the ID probe in the postoperative monitoring of free tissue transfers.

Original languageEnglish (US)
Pages (from-to)11-19
Number of pages9
JournalCanadian Journal of Plastic Surgery
Volume24
Issue number1
DOIs
StatePublished - Mar 1 2016

Keywords

  • Complications
  • Doppler
  • External
  • Free flap
  • Handheld
  • Implantable
  • Internal
  • Monitoring
  • Reconstruction

ASJC Scopus subject areas

  • Surgery

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