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

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. Study Design and Setting 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%. Conclusion 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. Significance May alter postoperative monitoring techniques of microvascular surgeons.