title: Implantable Doppler flow system: experience with 24 microvascular free-flap operations.
abstract: OBJECTIVE
  Microvascular reconstruction requires postoperative monitoring to prevent vascular occlusion and flap failure. These methods require skilled personnel and can delay diagnosis and treatment of threatened flap failures. The Cook-Swartz implantable Doppler flow system provides continual feedback on vascular pedicle status, which in turn provides rapid assessment of minute-to-minute changes in flap vasculature that may allow intervention before total vascular occlusion and expeditious reexploration for threatened flap failure, possibly improving flap salvage.
  
  
  METHODS
  Charts of 24 patients with microvascular free-flap reconstruction and implantation of Doppler flow system at Mayo Clinic Rochester were retrospectively reviewed. Surgical technique and flap outcomes were evaluated.
  
  
  RESULTS
  Microvascular reconstruction and implantation of Doppler flow system were successful in all patients. Complications were minimal, and postoperative monitoring system facilitated rapid reexploration when necessary. Flap viability was 96%.
  
  
  CONCLUSIONS
  Doppler flow system is reliable for monitoring minute-to-minute changes in microvascular flap vascular status postoperatively, and allows rapid recognition of complications and facilitating reexploration. This is a valuable, easily mastered tool for microvascular reconstructive surgery.
  
  
  CONCLUSIONS
  May alter postoperative monitoring techniques of microvascular surgeons.
authors.affiliation: Division of Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: Shepherd G
authors.initials: SG
authors.lastname: Pryor
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Moore
authors.forename: Jan L
authors.initials: JL
authors.lastname: Kasperbauer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D017078:Laser-Doppler Flowmetry / Q000295:instrumentation*; D008297:Male; D008833:Microcirculation / Q000601:surgery*; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation; D011182:Postoperative Care; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D013524:Surgical Flaps; D014463:Ultrasonography; D014656:Vascular Surgical Procedures / Q000379:methods