Postoperative monitoring of microsurgical free tissue transfers for head and neck reconstruction.
Approximately 10% of free tissue transfers fail because of thrombosis of the arterial or venous anastomoses. Postoperative monitoring to allow early detection of impaired flap perfusion is crucial, especially in head and neck reconstruction, in which failure of a free flap may be associated with significant morbidity. Furthermore, the increasing use of "buried" free tissue transfers in the head and neck precludes direct clinical observation. The various techniques that have been advocated for clinical monitoring of free tissue transfers are reviewed, and their potential applications in head and neck reconstruction are discussed with specific emphasis on the use of low-frequency continuous-wave Doppler surface monitoring and implantable high-frequency pulsed ultrasonic Doppler monitoring.
Jones
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NF
Division of Plastic Surgery, University of Pittsburgh, PA 15261.
D000818:Animals; D004285:Dogs; D006257:Head / Q000601:surgery*; D006801:Humans; D008866:Microsurgery; D008991:Monitoring, Physiologic; D009119:Muscle Contraction; D009333:Neck / Q000601:surgery*; D010100:Oxygen / Q000032:analysis; D010991:Plethysmography; D011182:Postoperative Care; D011817:Rabbits; D051381:Rats; D012212:Rheology; D012881:Skin Temperature; D013524:Surgical Flaps; D014463:Ultrasonography
D010100:Oxygen