Laser doppler surveillance of the circulation of free flaps and replanted digits

Abstract

In a series of 40 clinical free flaps and replantations the laser doppler technique has been used successfully for postoperative surveillance of circulation. A uniform flow pattern was obtained from all uncomplicated cases contrasting to the flow pattern seen in cases with thrombotic complication. The laser doppler continuously records flow of the microcirculation and is able to monitor blood flow in all types of free tissue transfer presently used as well as replantations. The laser doppler has effectively diagnosed two arterial thromboses with a characteristic flow pattern. It can distinguish venous from arterial occlusion. It can record flow in skin flaps which are difficult to judge clinically and in buried flaps, where no clinical observations are possible. The laser doppler should be used in conjunction with routine clinical observations.

Implantable Doppler flow system: Experience with 24 microvascular free‐flap operations

“…Numerous devices have been developed to assist in monitoring microvascular repair. The fluorescein monitor, 1 transcutaneous laser Doppler, 2 photoplethysmography, 3 transcutaneous PO 2 monitoring, 4 and optical spectroscopy 5 all depend on surface capillary phenomena that may or may not reflect what is occurring at the anastomotic site. Similarly, free‐tissue transfer in the oropharynx and hypopharynx that results in buried tissue is a challenge for even the most skilled staff to assess.…”

Distinguishing Laser Doppler Flowmetric Responses Between Arterial and Venous Obstructions in Flaps

“…Previous experimental studies have differentiated between arterial and venous occlusion by studying laser Doppler flowmetry, in combination with laser photometry [6][7][8] or waveform analysis. [9][10][11] In clinical practice, however, many authors rely solely on laser Doppler flowmetry for postoperative adjunctive monitoring of free flaps.…”

Evaluating Blood Flow in Full‐Thickness Skin Grafts Utilizing the Laser Doppler

“…This study allowed close clinical observation to be coupled with blood flow measurements utilizing the LDV to increase the understanding of FTSG physiology. The LDV has been used to study many clinical and experimental models, 21–31 but has not been used to study skin grafts. These skin grafts are such a common repair modality of surgical defects that they are almost taken for granted.…”