A contrivance for monitoring skin flaps with a Doppler flowmeter

A monitoring procedure using a Doppler flowmeter for assessment of patency after microvascular surgery is reported. Thirty-two free flaps were monitored using this procedure. There were three problematic cases in which flap circulation was not evaluated by the Doppler flowmeter. One involved the existence of another artery beneath the pedicle. The second was one of distal necrosis of the flap caused by impairment of peripheral blood circulation, in spite of patency of the pedicle. The third case involved venous occlusion of the pedicle, that was clinically detected by evaluating flap color, and the flap was salvaged. Checking beneath the pedicle prior to anastomosis was instituted after the first case cited, and there has not been a similar complication. The procedure has been proved to be useful in flap monitoring.