Free flap monitoring using simultaneous non-invasive laser Doppler flowmetry and tissue spectrophotometry
Early identification of flap failure is an indispensable prerequisite for flap salvage. Although many methods of free flap monitoring are available, there is still no single reliable non-invasive technique for early recognition of flap failure and for differentiation between arterial occlusion and v...
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| Veröffentlicht in: | Journal of cranio-maxillo-facial surgery 2006, Vol.34 (1), p.25-33 |
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| creator | Hölzle, Frank Loeffelbein, Denys John Nolte, Dirk Wolff, Klaus-Dietrich |
| description | Early identification of flap failure is an indispensable prerequisite for flap salvage. Although many methods of free flap monitoring are available, there is still no single reliable non-invasive technique for early recognition of flap failure and for differentiation between arterial occlusion and venous congestion. The aim of this study was to investigate the benefits of the tissue oxygen analysis system O2C for monitoring patients undergoing maxillofacial reconstruction with fasciocutaneous radial forearm flaps.
In a prospective clinical study the microcirculatory parameters of blood flow, flow velocity, haemoglobin concentration (AU, Arbitrary Units) and oxygen saturation (%) were assessed by clinical means, by laser Doppler flowmetry and tissue spectrophotometry in 61 patients intraoperatively. Measurements were carried out before flap harvest, in the separated radial forearm flap, immediately after anastomoses and up to 14 days after reconstruction.
Following anastomosis, blood flow and flow velocity exceeded the level before flap elevation and reached significant differences by the third postoperative day (
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| doi_str_mv | 10.1016/j.jcms.2005.07.010 |
| format | Article |
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In a prospective clinical study the microcirculatory parameters of blood flow, flow velocity, haemoglobin concentration (AU, Arbitrary Units) and oxygen saturation (%) were assessed by clinical means, by laser Doppler flowmetry and tissue spectrophotometry in 61 patients intraoperatively. Measurements were carried out before flap harvest, in the separated radial forearm flap, immediately after anastomoses and up to 14 days after reconstruction.
Following anastomosis, blood flow and flow velocity exceeded the level before flap elevation and reached significant differences by the third postoperative day (
p<0.05). Oxygen saturation decreased significantly by the third postoperative day and haemoglobin oxygenation showed stable values after performing anastomosis.
Simultaneous, non-invasive laser-Doppler flowmetry and tissue spectrophotometry detected vascular complications in all cases with no false positive or false negative results and prior to clinical assessment.
For the first time this new device allows reliable prediction of venous congestion by an increase of haemoglobin-concentration, and of arterial occlusion by a decrease in blood flow parameters and oxygen saturation. It can thus differentiate the mechanisms of flap failure before clinical assessment.</description><identifier>ISSN: 1010-5182</identifier><identifier>EISSN: 1878-4119</identifier><identifier>DOI: 10.1016/j.jcms.2005.07.010</identifier><identifier>PMID: 16343915</identifier><identifier>CODEN: JCMSET</identifier><language>eng</language><publisher>Kidlington: Elsevier Ltd</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anastomosis, Surgical ; Biological and medical sciences ; Blood Flow Velocity - physiology ; Cardiovascular system ; Dentistry ; Female ; Follow-Up Studies ; Forearm - surgery ; Graft Survival - physiology ; Hemoglobins - analysis ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; laser-Doppler flowmetry ; Laser-Doppler Flowmetry - instrumentation ; Male ; Medical sciences ; microvascular tissue transplantation ; Middle Aged ; Monitoring, Intraoperative - instrumentation ; Monitoring, Physiologic ; Otorhinolaryngology. Stomatology ; Oxygen - blood ; Prospective Studies ; Reconstructive Surgical Procedures - methods ; Regional Blood Flow - physiology ; Spectrophotometry - instrumentation ; Surgical Flaps - blood supply ; tissue spectrophotometry ; Ultrasonic investigative techniques ; Vascular Patency - physiology</subject><ispartof>Journal of cranio-maxillo-facial surgery, 2006, Vol.34 (1), p.25-33</ispartof><rights>2005 European Association for Cranio-Maxillofacial Surgery</rights><rights>2006 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-8219700818a52fe1940c21ce30dfa0ae7ab2a7839878751cab63eb9ebd05bb3f3</citedby><cites>FETCH-LOGICAL-c384t-8219700818a52fe1940c21ce30dfa0ae7ab2a7839878751cab63eb9ebd05bb3f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1010518205001174$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,4010,27900,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17383024$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16343915$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hölzle, Frank</creatorcontrib><creatorcontrib>Loeffelbein, Denys John</creatorcontrib><creatorcontrib>Nolte, Dirk</creatorcontrib><creatorcontrib>Wolff, Klaus-Dietrich</creatorcontrib><title>Free flap monitoring using simultaneous non-invasive laser Doppler flowmetry and tissue spectrophotometry</title><title>Journal of cranio-maxillo-facial surgery</title><addtitle>J Craniomaxillofac Surg</addtitle><description>Early identification of flap failure is an indispensable prerequisite for flap salvage. Although many methods of free flap monitoring are available, there is still no single reliable non-invasive technique for early recognition of flap failure and for differentiation between arterial occlusion and venous congestion. The aim of this study was to investigate the benefits of the tissue oxygen analysis system O2C for monitoring patients undergoing maxillofacial reconstruction with fasciocutaneous radial forearm flaps.
In a prospective clinical study the microcirculatory parameters of blood flow, flow velocity, haemoglobin concentration (AU, Arbitrary Units) and oxygen saturation (%) were assessed by clinical means, by laser Doppler flowmetry and tissue spectrophotometry in 61 patients intraoperatively. Measurements were carried out before flap harvest, in the separated radial forearm flap, immediately after anastomoses and up to 14 days after reconstruction.
Following anastomosis, blood flow and flow velocity exceeded the level before flap elevation and reached significant differences by the third postoperative day (
p<0.05). Oxygen saturation decreased significantly by the third postoperative day and haemoglobin oxygenation showed stable values after performing anastomosis.
Simultaneous, non-invasive laser-Doppler flowmetry and tissue spectrophotometry detected vascular complications in all cases with no false positive or false negative results and prior to clinical assessment.
For the first time this new device allows reliable prediction of venous congestion by an increase of haemoglobin-concentration, and of arterial occlusion by a decrease in blood flow parameters and oxygen saturation. It can thus differentiate the mechanisms of flap failure before clinical assessment.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anastomosis, Surgical</subject><subject>Biological and medical sciences</subject><subject>Blood Flow Velocity - physiology</subject><subject>Cardiovascular system</subject><subject>Dentistry</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Forearm - surgery</subject><subject>Graft Survival - physiology</subject><subject>Hemoglobins - analysis</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>laser-Doppler flowmetry</subject><subject>Laser-Doppler Flowmetry - instrumentation</subject><subject>Male</subject><subject>Medical sciences</subject><subject>microvascular tissue transplantation</subject><subject>Middle Aged</subject><subject>Monitoring, Intraoperative - instrumentation</subject><subject>Monitoring, Physiologic</subject><subject>Otorhinolaryngology. Stomatology</subject><subject>Oxygen - blood</subject><subject>Prospective Studies</subject><subject>Reconstructive Surgical Procedures - methods</subject><subject>Regional Blood Flow - physiology</subject><subject>Spectrophotometry - instrumentation</subject><subject>Surgical Flaps - blood supply</subject><subject>tissue spectrophotometry</subject><subject>Ultrasonic investigative techniques</subject><subject>Vascular Patency - physiology</subject><issn>1010-5182</issn><issn>1878-4119</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1v1DAQQCMEoh_wBzggX-CWdBwnsSNxQYWWSpW4lLPlOBPwyrGDJ9mq_75edqXeuHismTejmVcUHzhUHHh3tat2dqaqBmgrkBVweFWccyVV2XDev87_nCpbruqz4oJoBwAdqP5tccY70Yiet-eFu0mIbPJmYXMMbo3Jhd9so8NLbt78agLGjViIoXRhb8jtkXlDmNi3uCw-x8nHxxnX9MRMGNnqiDZktKBdU1z-xDX-K74r3kzGE74_xcvi1833h-sf5f3P27vrr_elFapZS1XzXgIorkxbT8j7BmzNLQoYJwMGpRlqI5Xo852y5dYMncChx2GEdhjEJC6Lz8e5S4p_N6RVz44sen88RHeyVVK2MoP1EbQpEiWc9JLcbNKT5qAPgvVOHwTrg2ANUmebuenjafo2zDi-tJyMZuDTCTBkjZ-SCdbRCyeFElA3mfty5DC72DtMmqzDYHF0KZvTY3T_2-MZ1L6cOQ</recordid><startdate>2006</startdate><enddate>2006</enddate><creator>Hölzle, Frank</creator><creator>Loeffelbein, Denys John</creator><creator>Nolte, Dirk</creator><creator>Wolff, Klaus-Dietrich</creator><general>Elsevier Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2006</creationdate><title>Free flap monitoring using simultaneous non-invasive laser Doppler flowmetry and tissue spectrophotometry</title><author>Hölzle, Frank ; Loeffelbein, Denys John ; Nolte, Dirk ; Wolff, Klaus-Dietrich</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c384t-8219700818a52fe1940c21ce30dfa0ae7ab2a7839878751cab63eb9ebd05bb3f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anastomosis, Surgical</topic><topic>Biological and medical sciences</topic><topic>Blood Flow Velocity - physiology</topic><topic>Cardiovascular system</topic><topic>Dentistry</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Forearm - surgery</topic><topic>Graft Survival - physiology</topic><topic>Hemoglobins - analysis</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>laser-Doppler flowmetry</topic><topic>Laser-Doppler Flowmetry - instrumentation</topic><topic>Male</topic><topic>Medical sciences</topic><topic>microvascular tissue transplantation</topic><topic>Middle Aged</topic><topic>Monitoring, Intraoperative - instrumentation</topic><topic>Monitoring, Physiologic</topic><topic>Otorhinolaryngology. Stomatology</topic><topic>Oxygen - blood</topic><topic>Prospective Studies</topic><topic>Reconstructive Surgical Procedures - methods</topic><topic>Regional Blood Flow - physiology</topic><topic>Spectrophotometry - instrumentation</topic><topic>Surgical Flaps - blood supply</topic><topic>tissue spectrophotometry</topic><topic>Ultrasonic investigative techniques</topic><topic>Vascular Patency - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hölzle, Frank</creatorcontrib><creatorcontrib>Loeffelbein, Denys John</creatorcontrib><creatorcontrib>Nolte, Dirk</creatorcontrib><creatorcontrib>Wolff, Klaus-Dietrich</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cranio-maxillo-facial surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hölzle, Frank</au><au>Loeffelbein, Denys John</au><au>Nolte, Dirk</au><au>Wolff, Klaus-Dietrich</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Free flap monitoring using simultaneous non-invasive laser Doppler flowmetry and tissue spectrophotometry</atitle><jtitle>Journal of cranio-maxillo-facial surgery</jtitle><addtitle>J Craniomaxillofac Surg</addtitle><date>2006</date><risdate>2006</risdate><volume>34</volume><issue>1</issue><spage>25</spage><epage>33</epage><pages>25-33</pages><issn>1010-5182</issn><eissn>1878-4119</eissn><coden>JCMSET</coden><abstract>Early identification of flap failure is an indispensable prerequisite for flap salvage. Although many methods of free flap monitoring are available, there is still no single reliable non-invasive technique for early recognition of flap failure and for differentiation between arterial occlusion and venous congestion. The aim of this study was to investigate the benefits of the tissue oxygen analysis system O2C for monitoring patients undergoing maxillofacial reconstruction with fasciocutaneous radial forearm flaps.
In a prospective clinical study the microcirculatory parameters of blood flow, flow velocity, haemoglobin concentration (AU, Arbitrary Units) and oxygen saturation (%) were assessed by clinical means, by laser Doppler flowmetry and tissue spectrophotometry in 61 patients intraoperatively. Measurements were carried out before flap harvest, in the separated radial forearm flap, immediately after anastomoses and up to 14 days after reconstruction.
Following anastomosis, blood flow and flow velocity exceeded the level before flap elevation and reached significant differences by the third postoperative day (
p<0.05). Oxygen saturation decreased significantly by the third postoperative day and haemoglobin oxygenation showed stable values after performing anastomosis.
Simultaneous, non-invasive laser-Doppler flowmetry and tissue spectrophotometry detected vascular complications in all cases with no false positive or false negative results and prior to clinical assessment.
For the first time this new device allows reliable prediction of venous congestion by an increase of haemoglobin-concentration, and of arterial occlusion by a decrease in blood flow parameters and oxygen saturation. It can thus differentiate the mechanisms of flap failure before clinical assessment.</abstract><cop>Kidlington</cop><pub>Elsevier Ltd</pub><pmid>16343915</pmid><doi>10.1016/j.jcms.2005.07.010</doi><tpages>9</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over Anastomosis, Surgical Biological and medical sciences Blood Flow Velocity - physiology Cardiovascular system Dentistry Female Follow-Up Studies Forearm - surgery Graft Survival - physiology Hemoglobins - analysis Humans Investigative techniques, diagnostic techniques (general aspects) laser-Doppler flowmetry Laser-Doppler Flowmetry - instrumentation Male Medical sciences microvascular tissue transplantation Middle Aged Monitoring, Intraoperative - instrumentation Monitoring, Physiologic Otorhinolaryngology. Stomatology Oxygen - blood Prospective Studies Reconstructive Surgical Procedures - methods Regional Blood Flow - physiology Spectrophotometry - instrumentation Surgical Flaps - blood supply tissue spectrophotometry Ultrasonic investigative techniques Vascular Patency - physiology |
| title | Free flap monitoring using simultaneous non-invasive laser Doppler flowmetry and tissue spectrophotometry |
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