The effect of an implantable Doppler probe on the salvage of microvascular tissue transplants.
One hundred forty-seven flaps in 135 consecutive patients undergoing microvascular transplantation were monitored using a miniature Doppler ultrasonic probe. Using a modification of a technique described previously by Swartz, the probes were secured to the outflow vein of the flap with Vicryl mesh. Twenty instances of thrombosis or spasm were detected in 16 patients, and all flaps were salvaged (100 percent). There were four false positive and no false negative results. This probe allows for safe, continuous monitoring of flap blood flow, which permits the rapid detection and hence rapid treatment of postoperative complications. Our experience suggests that a significant improvement in the salvage rate of microvascular transplants may be attainable with the use of this device.
Kind
G M
GM
Microsurgical Replantation Transplantation Department of Daives Medical Center, San Francisco, Calif 94114, USA.
Buntic
R F
RF
Buncke
G M
GM
Cooper
T M
TM
Siko
P P
PP
Buncke
H J
HJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D005189:False Positive Reactions; D005260:Female; D006085:Graft Survival; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000009:adverse effects; D008875:Middle Aged; D008904:Miniaturization; D008991:Monitoring, Physiologic / Q000295:instrumentation; D011098:Polyglactin 910; D019736:Prostheses and Implants; D012039:Regional Blood Flow; D012449:Safety; D013524:Surgical Flaps / Q000009:adverse effects / Q000098:blood supply*; D013526:Surgical Mesh; D013927:Thrombosis / Q000175:diagnosis / Q000601:surgery; D018608:Ultrasonography, Doppler / Q000295:instrumentation*; D014661:Vasoconstriction; D014680:Veins / Q000637:transplantation
D011098:Polyglactin 910