Venous Flow Coupler in Head and Neck Free Flap Reconstruction

Area of Science:

• Microsurgery
• Surgical Technology
• Postoperative Monitoring

Background:

• Free tissue flap reconstruction is a cornerstone of reconstructive surgery.
• Effective postoperative monitoring is crucial for flap viability.
• Early detection of vascular compromise, particularly venous thrombosis, is essential for successful flap salvage.

Purpose of the Study:

• To evaluate the clinical utility of venous flow couplers in monitoring free tissue flaps.
• To assess the role of venous flow couplers in detecting venous thrombosis in the immediate postoperative period.
• To determine the impact of venous flow couplers on flap salvage rates.

Main Methods:

• A retrospective case series of free flap reconstructions over four years.
• Inclusion criteria involved monitoring with venous flow couplers and arterial flow Doppler for five days postoperatively.
• Data analysis focused on flap compromise, salvage rates, and the diagnostic performance of venous flow couplers.

Main Results:

• Out of 217 analyzed cases, 9.2% required reoperation for flap compromise, with 16 flaps successfully salvaged.
• Venous flow couplers, in conjunction with arterial flow Doppler, identified 19 compromised flaps.
• Venous flow couplers detected 5 flaps with venous thrombosis prior to arterial signal changes, leading to successful salvage.

Conclusions:

• Venous flow couplers demonstrate utility in monitoring free tissue flaps.
• This device can detect venous thrombosis independently of arterial compromise, contributing to improved flap salvage.
• Venous flow couplers represent a valuable adjunct in the early detection of vascular complications in free flaps.