Free flap monitoring using simultaneous non-invasive laser Doppler flowmetry and tissue spectrophotometry

Hölzle, Frank; Loeffelbein, Denys J.; Nölte, D.; Wolff, Klaus‐Dietrich

doi:10.1016/j.jcms.2005.07.010

Cited by 181 publications

(238 citation statements)

References 43 publications

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“…Values of haemoglobin oxygenation below 15% and of blood flow at 2 mm tissue depth below 10 AU were highly predictive of the onset of failure in radial forearm flaps [10]. On the other hand, in another study significant differences of cutaneous haemoglobin oxygenation existed between the most donor sites [29].…”

Section: Discussionmentioning

confidence: 83%

“…On day 16, a 6-hr ischemia was well tolerated by the flaps which showed definite capillary refill, even in the centre. Because the flap showed on the one hand a good capillary refill during the pedicle occlusion and on the other hand the measurements of the flap were above the critical limit [10], the decision was made to remove the pedicle of the flap after two prolonged ischemia intervals (6 hr) for another day. Consequently, the carrier flap including the radial artery as well as the cephalic vein bridge were removed on day 18.…”

Section: Resultsmentioning

confidence: 99%

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Rapid autonomisation of a combined fibular‐ and anterolateral thigh flap transferred by a wrist carrier to an irradiated and vessel depleted neck

Wolff

Mücke

Lehmbrock

et al. 2008

Journal of Surgical Oncology

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In an irradiated and vessel depleted neck, we used the wrist carrier technique to provide flap perfusion until autonomisation took place. A combined anterolateral thigh- and osteocutaneous fibular flap was anastomosed to the radial vessels of an irradiated patient with a vessel depleted neck for reconstruction of the lower face. Periodical pedicle occlusion started immediately after surgery. On day 16, cutaneous blood flow and oxygenation were still reduced, but wound healing was uneventful.

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Section: Discussionmentioning

confidence: 83%

Section: Resultsmentioning

confidence: 99%

Rapid autonomisation of a combined fibular‐ and anterolateral thigh flap transferred by a wrist carrier to an irradiated and vessel depleted neck

Wolff

Mücke

Lehmbrock

et al. 2008

Journal of Surgical Oncology

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“…Recently, we have used noninvasive laser Doppler flowmetry and implantable Doppler in selected high risk flaps, such as those with difficult anastomoses, buried flaps, and take-back flaps, where the skin is no longer a reliable monitor. Although many methods of free flap monitoring are available, 12,13 there is still no consensus on the most reliable noninvasive technique for early recognition of flap failure.…”

Section: Discussionmentioning

confidence: 99%

Microvascular breast reconstruction pedicle thrombosis: How long can we wait?

Vijan

Tran

2007

Microsurgery

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Re-exploration plays a key role in salvaging vascularly compromised free flaps. A retrospective review of 290 free flaps in breast reconstruction was performed to determine whether the time delay between thrombosis detection and surgical re-exploration had any effect on flap salvage. Overall flap success was 97.6%. Postoperative thrombosis requiring re-exploration was documented in 6.2% cases. Fifty-five percent of take-back flaps were salvaged and 45% were lost. The median time between detection of flap compromise to surgical incision was 128 min in our saved flaps, and 228 min in the lost flap group. Our preliminary data suggests that re-exploration within 188 min may improve flap salvage.

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“…8,9 Newer methods that have been developed for monitoring are tissue spectophotometry, laser Doppler flowmetry, and tissue oxygen pressure measuring probes. [10][11][12] Although the conventional techniques mentioned above are reliable in most flaps, they are not in buried flaps because of their external component. 3,13 To better monitor buried flaps implantable Doppler probes are available.…”

mentioning

confidence: 99%