Eight-year experience of the Cook-Swartz Doppler in free-flap operations: Microsurgical and reexploration results with regard to a wide spectrum of surgeries
Article first published online: 3 AUG 2010
Copyright © 2010 Wiley-Liss, Inc.
Volume 31, Issue 1, pages 1–6, January 2011
How to Cite
Schmulder, A., Gur, E. and Zaretski, A. (2011), Eight-year experience of the Cook-Swartz Doppler in free-flap operations: Microsurgical and reexploration results with regard to a wide spectrum of surgeries. Microsurgery, 31: 1–6. doi: 10.1002/micr.20816
- Issue published online: 4 JAN 2011
- Article first published online: 3 AUG 2010
- Manuscript Accepted: 27 MAY 2010
- Manuscript Received: 20 JAN 2010
Microvascular free flap has become an increasingly popular useful method of reconstruction over the past few decades. Minimizing failure rates in these operations is a primary goal in every microsurgical unit that can be accomplished by early recognition.
In this retrospective study, we tracked the admission of the implantable Doppler in the microsurgical unit (2000–2007) and evaluated parameters measured from 473 consecutive patients who underwent a total of 548 microsurgical procedures (489 primary surgeries and 59 reexplorations). The effectiveness of the Cook-Swartz Doppler (Cook Medical®) was examined in juxtapose general and subspecialty's aspects: in each microsurgical subspecialty, we compared the overall success and failure rates of the group with the implantable Doppler (n = 259) with the control group monitored by clinical means (n = 289). We also examined the duration, outcomes, and the effectiveness of this device in reexploration operations.
Overall, success rates were improved by using the implantable Doppler contrary to clinical assessment (96.14% vs. 89.27%) with a statistical significant (P < 0.005). The device was most effective in ENT (94.6% vs. 84%), breast reconstructive surgeries (97.3% vs. 82.36%), and orthopedic oncology (97.37% vs. 83.72%), whereas with reanimation operations and trauma/orthopedics subspecialties, it showed no necessity. In neurosurgery and in other/esthetic surgeries, the study was too small to draw definite deductions.
We recommend the usage of the implantable Doppler probe as an effective monitoring system for free-flap surgeries, with emphasis on subspecialties where the device demonstrated better results than traditional monitoring methods. © 2010 Wiley-Liss, Inc. Microsurgery, 2011.