Post-operative monitoring of free muscle transfers by Laser Doppler Imaging: A prospective study.

Tschumi, Christian; Seyed Jafari, Seyed Morteza; Rothenberger, Jens; Van de Ville, Dimitri; Keel, Marius; Krause, Fabian; Shafighi, Maziar (2015). Post-operative monitoring of free muscle transfers by Laser Doppler Imaging: A prospective study. Microsurgery, 35(7), pp. 528-535. Wiley-Liss 10.1002/micr.22469

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PURPOSE Despite different existing methods, monitoring of free muscle transfer is still challenging. In the current study we evaluated our clinical setting regarding monitoring of such tissues, using a recent microcirculation-imaging camera (EasyLDI) as an additional tool for detection of perfusion incompetency. PATIENTS AND METHODS This study was performed on seven patients with soft tissue defect, who underwent reconstruction with free gracilis muscle. Beside standard monitoring protocol (clinical assessment, temperature strips, and surface Doppler), hourly EasyLDI monitoring was performed for 48 hours. Thereby a baseline value (raised flap but connected to its vascular bundle) and an ischaemia perfusion value (completely resected flap) were measured at the same point. RESULTS The mean age of the patients, mean baseline value, ischaemia value perfusion were 48.00 ± 13.42 years, 49.31 ± 17.33 arbitrary perfusion units (APU), 9.87 ± 4.22 APU, respectively. The LDI measured values in six free muscle transfers were compatible with hourly standard monitoring protocol, and normalized LDI values significantly increased during time (P < 0.001, r = 0.412). One of the flaps required a return to theatre 17 hours after the operation, where an unsalvageable flap loss was detected. All normalized LDI values of this flap were under the ischaemia perfusion level and the trend was significantly descending during time (P < 0.001, r = -0.870). CONCLUSION Due to the capability of early detection of perfusion incompetency, LDI may be recommended as an additional post-operative monitoring device for free muscle flaps, for early detection of suspected failing flaps and for validation of other methods.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery > Plastic, Reconstructive and Aesthetic Surgery
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery
04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Dermatology

UniBE Contributor:

Tschumi, Christian; Seyed Jafari, Seyed Morteza; Rothenberger, Jens; Keel, Marius; Krause, Fabian and Shafighi, Maziar

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0738-1085

Publisher:

Wiley-Liss

Language:

English

Submitter:

Sandra Nyffenegger

Date Deposited:

29 Feb 2016 15:32

Last Modified:

13 Sep 2017 17:49

Publisher DOI:

10.1002/micr.22469

PubMed ID:

26260737

BORIS DOI:

10.7892/boris.76293

URI:

https://boris.unibe.ch/id/eprint/76293

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