Color duplex sonography for the monitoring of vascularized free bone flaps.
OBJECTIVE
When vascular complications are suspected after the microsurgical transfer of free buried fibular bone flaps without a skin island, revision surgery often proves to be unnecessary. We sought to determine the efficacy of color duplex sonography in the close observation of bone graft patency postoperatively. Study design Twelve free fibular bone flaps without a skin island were postoperatively monitored through color duplex sonography with a 7.5-MHz scanner.


RESULTS
With color duplex sonography, the rate of perfusion in the vascular pedicle could be visualized in all 12 fibular flaps. In 3 patients, vascular complications and flap failure were suspected. However, because adequate perfusion of the vascular pedicle was observed immediately after surgery and in the daily follow-up examinations, revision surgery was not necessary.


CONCLUSIONS
Color duplex sonography is not time-consuming; in fact, it is a reliable, noninvasive, and inexpensive method for the postoperative monitoring of free bone flaps.
Schön
Ralf
R
Department of Oral and Maxillofacial Surgery, Albert-Ludwigs Universität. schoen@zmk2.ukl.uni-freiburg.de
Schramm
Alexander
A
Gellrich
Nils-Claudius
NC
Maier
Wolfgang
W
Düker
Jürgen
J
Schmelzeisen
Rainer
R
D016025:Bone Transplantation / Q000000981:diagnostic imaging*; D005360:Fibula / Q000098:blood supply / Q000000981:diagnostic imaging / Q000637:transplantation; D006801:Humans; D008991:Monitoring, Physiologic / Q000379:methods; D019647:Oral Surgical Procedures / Q000379:methods*; D011184:Postoperative Period; D013524:Surgical Flaps / Q000098:blood supply*; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color / Q000379:methods*; D014654:Vascular Patency