Postoperative monitoring of microsurgical free-tissue transfers for head and neck reconstruction: a systematic review of current techniques-Part II. Invasive techniques
ABSTRACT A systematic review of the literature relating to methods of monitoring viability of microvascular free-tissue transfers in the head and neck region was conducted. The aim of this review is to identify the best method of monitoring that would allow timely salvage of potentially failing free flaps. An analysis and description of the various studied techniques is also given. In this second part, invasive modalities are covered.
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ABSTRACT: OBJECTIVE: The purpose of this paper is to evaluate the efficacy and cost-effectiveness of the implantable Doppler system based on the analysis of the available scientific literature and clinical and cost data available in our hospital. The results of this system are compared to those of conventional free flap monitoring methods. MATERIALS AND METHODS: The literature published between 1991 and 2011 was systematically reviewed. All available cost data were collected and several simulations were performed. A retrospective assessment of the efficacy of conventional methods in our hospital was also conducted. RESULTS AND CONCLUSION: The implantable Doppler system is more effective than the conventional methods used to monitor free flap perfusion. The mean flap salvage rate with the implantable Doppler was 21 percentage points higher (81.4 vs. 60.4). The excess cost compared to conventional methods was about CAD 120 per patient (about EUR 94). However, this excess cost can be compensated or even reversed, depending on the initial flap salvage rate in the health facility and the type of free flap (buried vs. non-buried).European Annals of Otorhinolaryngology, Head and Neck Diseases 04/2013; 130(2):79-85. DOI:10.1016/j.anorl.2012.07.003
- British Journal of Oral and Maxillofacial Surgery 08/2009; 47(7):574-5. DOI:10.1016/j.bjoms.2009.05.013
- British Journal of Oral and Maxillofacial Surgery 08/2009; 47(7):573-4. DOI:10.1016/j.bjoms.2009.02.019