Flap Monitoring (Post-Op)
Tissue blood flow measurements of flaps and replanted tissues provided by laser Doppler can be used to provide an early indication of flap failure before clinical signs are apparent. Both surface and buried flaps can be monitored. Alarm levels will be automatically set by the moorVMS-TREND system following a 30-minute baseline measurement. The alarm level can also be set manually if preferred (or values other than 60% chosen) and are set relative to baseline flow rather than for 'normal' values because of natural spatial variations in flow. Signs of a healthy flap are a pulsatile LD blood flow waveform due to the cardiac cycle and a stable or steadily increasing trend. Fluctuations in LD blood flow are also good signs. These are due to vasomotion and physiological responses. Signs of a failing flap include lack of pulsatility, a falling trend and lack of fluctuations.
The moorVMS-TREND software package enables monitoring from moorVMS-LDF and moorVMS-OXY monitors. Probes are available for surface (VP1T or VP1T/7 probes) flaps, under bandage use (VP8c or VP11sc) and buried flaps (VP6asd). The main advantage of monitoring is the continuous nature of the monitoring and the automatic alarm indicating potential flap failure. Probes are available to assist with monitoring of flaps in the fields of plastic and maxillofacial surgery, including TRAM, DIEP, SIEA and SIEP. Research into use of imaging (moorFLPI-2) is on going with the advantage of a spatial assessment of flow over the entire exposed flap.
Contact us to discuss your specific needs and to request your copy of our free Application Note which includes a detailed experimental method and practical suggestions. We also offer no obligation on-site visits so you can test the equipment in your facility.
Dorai, A. 2006. Laser doppler monitoring of free flaps in reconstructive microsurgery. Malays J Med Sci. 2006 January;, (13(1)), pp.79–96.
Figus , A., Mosahebi , A., and Ramakrishnan , V., 2006. Microcirculation in DIEP flaps: a study of the haemodynamics using laser Doppler flowmetry and lightguide reflectance spectrophotometry. Journal of plastic, reconstructive & aesthetic surgery: JPRAS, 59(6), pp.604–12; discussion 613.