RESUMO
Over a 5-year period, 232 microvascular composite-tissue transfers to the head and neck, trunk, and extremities were monitored using the laser Doppler flowmeter. Thirteen free flaps (5.6 percent) developed vascular complications, all within 4 days after surgery. The laser Doppler flowmeter detected vascular compromise in all cases with no false positives or negatives. Failure to monitor the flap according to protocol by nursing staff occurred in one patient, which led to a delay in detection of venous compromise and subsequent flap loss. The salvage rate was 69.2 percent, leading to an overall flap viability of 98.3 percent. Our series of free-flap monitoring using the laser Doppler flowmeter is the largest reported to date. Review of the English literature shows consistent support by numerous clinical series for the use of the laser Doppler as a valuable postoperative monitor after free-flap transfers.
Assuntos
Fluxometria por Laser-Doppler , Retalhos Cirúrgicos/irrigação sanguínea , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Velocidade do Fluxo Sanguíneo/fisiologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Fluxometria por Laser-Doppler/enfermagem , Masculino , Microcirurgia/enfermagem , Pessoa de Meia-Idade , Avaliação em Enfermagem , Complicações Pós-Operatórias/fisiopatologia , Sobrevivência de Tecidos/fisiologia , Resultado do TratamentoRESUMO
Thirty-four vascular and general surgical patients were recruited to a pilot study exploring skin blood flow using laser Doppler imaging and clinical assessment of skin erythema in relation to pressure sore development. Brief details of the results, sample size calculations and main study methodology are described in this mid-term report of the Tissue Viability Society Research Fellowship (1998-2000).
