title: Implantable Doppler Probes for Postoperatively Monitoring Free Flaps: Efficacy. A Systematic Review and Meta-analysis.
abstract: BACKGROUND
  Although clinical assessment remains the gold standard for monitoring the circulation of free flaps, several adjunct techniques promote timely salvage by detecting circulation compromise early. The objective of this systematic review was to evaluate the efficacy of an implantable Doppler probe for postoperatively monitoring free flaps.
  
  
  METHODS
  English-language articles evaluating the efficacy of implantable Doppler probes compared with clinical assessment for postoperatively monitoring free flaps were analyzed. The outcome measures were total flap failure rates, salvage rates, sensitivity, false-positive rates, and positive likelihood ratios.
  
  
  RESULTS
  Of the 504 citations identified, 6 comparative studies were included for meta-analysis. An implantable Doppler probe significantly lowered the flap failure rate (risk ratio: 0.40; 95% confidence interval: 0.21-0.75) and raised the successful salvage rate (risk ratio: 1.73; 95% confidence interval: 1.16-2.59). Pooled sensitivity was higher (1.00 vs 0.98), the positive likelihood ratio was lower (72.16 vs 220.48), and the false-positive rate was higher (0.01 vs 0) in the implantable Doppler probe group than in the clinical assessment group.
  
  
  CONCLUSIONS
  An implantable Doppler probe is significantly more efficacious than clinical assessment for postoperatively monitoring free flaps.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan; Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; and Department of Surgery, Queen Mary Hospital, Pok Fu Lam, Hong Kong.
authors.forename: Tzu-Yen
authors.initials: TY
authors.lastname: Chang
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan; Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; and Department of Surgery, Queen Mary Hospital, Pok Fu Lam, Hong Kong.
authors.forename: Yao-Chou
authors.initials: YC
authors.lastname: Lee
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan; Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; and Department of Surgery, Queen Mary Hospital, Pok Fu Lam, Hong Kong.
authors.forename: You-Cheng
authors.initials: YC
authors.lastname: Lin
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan; Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; and Department of Surgery, Queen Mary Hospital, Pok Fu Lam, Hong Kong.
authors.forename: Stanley Thian-Sze
authors.initials: ST
authors.lastname: Wong
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan; Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; and Department of Surgery, Queen Mary Hospital, Pok Fu Lam, Hong Kong.
authors.forename: Yuan-Yu
authors.initials: YY
authors.lastname: Hsueh
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan; Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; and Department of Surgery, Queen Mary Hospital, Pok Fu Lam, Hong Kong.
authors.forename: Yao-Lung
authors.initials: YL
authors.lastname: Kuo
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan; Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; and Department of Surgery, Queen Mary Hospital, Pok Fu Lam, Hong Kong.
authors.forename: Shyh-Jou
authors.initials: SJ
authors.lastname: Shieh
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan; Division of Plastic and Reconstructive Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; and Department of Surgery, Queen Mary Hospital, Pok Fu Lam, Hong Kong.
authors.forename: Jing-Wei
authors.initials: JW
authors.lastname: Lee