Doppler Comparative Measurements in the Reconstruction of Limbs with Flaps and Grafts

Abstract

Abstract Doppler technique was first described by the Australian physicist and mathematician Christian Doppler. Doppler effect is defined as a reflection of high frequency sound waves of different frequency when they come in contact with the movable structure in the blood vessel. Waves that go to transducers are coded red, while waves that move away from the transducer are coded blue. Doppler main types can be classified as following: continuous wave (CW) Doppler, spectral Doppler, color Doppler and Power Doppler color. The study was realizedat the University Clinic for Plastic and Reconstructive Surgery. It is a randomized prospective study. During the study two groups of 30 patientseach were formed. Each patient was required a permission for reconstructive surgery procedure and an informed consent for participation in the study. For all patients a specially designed questionnaire (non-standardized) was filled out. 1. First (I) group of patients treated with flaps. In this group a type of reconstructive technique with skin or complex flapshas been applied. 2. Second group (II) of patients treated with grafts (split thickness grafts). In this group applied reconstruction comprised application of skin grafts with partial thickness. The study included patients with defects of the skin and soft tissues, whohad an indication for reconstructive surgery procedure. Exclusion criteria of patients for participation in the study were: children under 14 years of age, adults over 75 years, people with systemic diseases that can affect the results of reconstructive intervenetions and patients who have without periosteum bone-like surface defect as contraindication for skin grafting. The results of the reconstructive procedures according to the objectives set were investigated clinically into three time periods: preoperative, postoperative day 7 and day 30 postoperatively. The following investigations were carried out: determination of the circulation levels by means of Doppler; determination of the levels of limbs circulation is distal to the site of reconstruction in the pre-and postoperative period (day 7 and day 30); For the evaluation of blood flow the following parameters were used: • PSV-Peak systolic velocity • PI - Pulsatility index RI - Resistance indexPI and RI were calculated using the formula: • PI = PSV - EDV / Vmean • RI = PSV - EDV / PSV EDV indicates the flow velocity in late diastole and V mean, the average speed of blood flow through the artery. By assessment of arterial status before and after surgery through the analysis ofvascular waves at different locations of the vascular tree of the upper and lower extremities, we registered significant difference between the two examined groups, which speaks in favor of the use of flaps in reconstruction of the lower limbs.