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Portable-Type Laser Doppler Flowmetry Monitoring for Free Tissue Transfers: Factors That Affects Free Flap Blood

Shuchi Azuma^1,2, Aya Onodera¹, Nobuyuki Mitsuhashi¹

¹Department of Plastic and Reconstructive Surgery, Iwate Medical University, Yahaba, Iwate, Japan.

|July 14, 2026

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Portable Laser Doppler flowmetry (pLDF) monitoring of free flaps is influenced by mean blood pressure and hemoglobin levels. This study provides an objective formula to differentiate systemic changes from local complications, improving flap monitoring.

Area of Science:

Plastic Surgery
Vascular Surgery
Biomedical Engineering

Background:

Traditional Laser Doppler flowmetry (LDF) devices for free flap monitoring are often bulky and difficult to interpret.
Portable LDF (pLDF) offers a lightweight and mobile alternative for enhanced clinical utility.
Objective interpretation of pLDF requires understanding systemic factors influencing its readings.

Purpose of the Study:

To identify systemic factors that significantly affect portable Laser Doppler flowmetry (pLDF) values in free flap monitoring.
To establish a quantitative relationship between systemic parameters and flap blood flow measurements.
To enable more objective clinical interpretation of pLDF data.

Main Methods:

Retrospective review of 65 free flaps in 64 patients monitored with pLDF over three years.

Keywords:

Hemodilution free flap monitoring free tissue transfer laser Doppler flowmetry mixed‐effects model

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Application of a mixed-effects model to analyze factors influencing pLDF values.

Statistical analysis to determine the impact of mean blood pressure and hemoglobin concentration on pLDF.

Main Results:

Two flaps (2.9%) experienced vascular compromise, with one successfully salvaged.
pLDF values were significantly correlated with mean blood pressure (mBP) and hemoglobin concentration (Hb).
Increased mBP and decreased Hb showed a significant positive correlation with pLDF values (p < 0.001).

Conclusions:

A quantitative relationship between systemic parameters (mBP, Hb) and pLDF measurements was established.
A 1 g/dL change in Hb is equivalent to a 9 mmHg change in mBP in its effect on pLDF.
The findings provide an objective formula for interpreting pLDF data, aiding in distinguishing systemic from local flap complications.