Free flaps monitoring by Laser-Doppler Flowmetry in head and neck surgery.

IF 2.1 4区医学 Q2 OTORHINOLARYNGOLOGY Acta Otorhinolaryngologica Italica Pub Date : 2022-10-01 DOI:10.14639/0392-100X-N1956

Pietro Salvatori, Stefano Paradisi, Andrea Zani

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Abstract

Objective: Early recognition of free flap vascular impairment is essential for flap salvage attempts. Several methods for surveillance of post-operative flaps are available. Among these, we have extensively used Laser-Doppler Perfusion Flowmetry (LDF) monitoring. We report our experience on this topic and illustrate the advantages and weak points.

Methods: Over seven years, 110 consecutive free flaps for head and neck reconstruction were monitored using the Periflux System 5000^® (Perimed AB, Järfälla, Sweden). In addition to maximum and minimum peaks, a pattern called vasomotion can be detected. Monitoring time lasted from 3 to 7 days, 24/24 h.

Results: Six of 110 (5.5%) cases of vascular problems were detected and clinically confirmed. In 5 cases, venous thrombosis was present: 4 patients were successfully treated. In 1 case, both arterial and venous thrombosis occurred. Flowmetry data always showed a more or less sudden disappearance of vasomotion.

Conclusions: LDF is a highly sensible, specific and reliable method. It is easy to use and interpret at low cost. Remote monitoring could also be developed.

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激光多普勒血流法在头颈部手术中的自由皮瓣监测。

目的:早期识别游离皮瓣血管损伤对皮瓣修复至关重要。有几种方法可用于术后皮瓣的监测。其中，我们广泛使用激光多普勒灌注血流法(LDF)监测。我们报告了我们在这个主题上的经验，并说明了优点和缺点。方法:使用Periflux System 5000®(Perimed AB, Järfälla，瑞典)监测7年来连续110例头颈部重建游离皮瓣。除了最大和最小峰值外，还可以检测到一种称为血管舒缩的模式。监测时间为3 ~ 7 d, 24/24 h。结果:110例患者中，检出血管病变6例(5.5%)并临床确诊。5例出现静脉血栓形成，4例治疗成功。1例同时发生动脉和静脉血栓形成。血流数据总是显示血管舒缩或多或少突然消失。结论:LDF是一种灵敏、特异、可靠的方法。它易于使用和解释，成本低。还可以发展远程监测。

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来源期刊

Acta Otorhinolaryngologica Italica OTORHINOLARYNGOLOGY-

CiteScore

3.40

自引率

10.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Acta Otorhinolaryngologica Italica first appeared as “Annali di Laringologia Otologia e Faringologia” and was founded in 1901 by Giulio Masini. It is the official publication of the Italian Hospital Otology Association (A.O.O.I.) and, since 1976, also of the Società Italiana di Otorinolaringoiatria e Chirurgia Cervico-Facciale (S.I.O.Ch.C.-F.). The journal publishes original articles (clinical trials, cohort studies, case-control studies, cross-sectional surveys, and diagnostic test assessments) of interest in the field of otorhinolaryngology as well as clinical techniques and technology (a short report of unique or original methods for surgical techniques, medical management or new devices or technology), editorials (including editorial guests – special contribution) and letters to the Editor-in-Chief. Articles concerning science investigations and well prepared systematic reviews (including meta-analyses) on themes related to basic science, clinical otorhinolaryngology and head and neck surgery have high priority.