A chimaeric-pattern flap design for implantable Doppler surrogate monitoring: a novel placement technique.
Identifieur interne : 001759 ( PubMed/Curation ); précédent : 001758; suivant : 001760A chimaeric-pattern flap design for implantable Doppler surrogate monitoring: a novel placement technique.
Auteurs : Jeong Tae Kim [Corée du Sud] ; Samuel Y M. Ho [Singapour] ; Youn Hwan Kim [Corée du Sud]Source :
- Journal of plastic, reconstructive & aesthetic surgery : JPRAS [ 1878-0539 ] ; 2014.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Blessures de la main (), Carcinome épidermoïde (), Débit sanguin régional, Effet Doppler, Humains, Implantation de prothèse (), Lambeaux tissulaires libres (), Monitorage physiologique (instrumentation), Mâle, Prothèses et implants, Soins postopératoires, Sujet âgé, Tumeurs de l'amygdale (), Tumeurs des sinus maxillaires ().
- MESH :
- Adulte d'âge moyen, Blessures de la main, Carcinome épidermoïde, Débit sanguin régional, Effet Doppler, Humains, Implantation de prothèse, Lambeaux tissulaires libres, Monitorage physiologique, Mâle, Prothèses et implants, Soins postopératoires, Sujet âgé, Tumeurs de l'amygdale, Tumeurs des sinus maxillaires.
English descriptors
- KwdEn :
- Aged, Carcinoma, Squamous Cell (surgery), Doppler Effect, Free Tissue Flaps (blood supply), Hand Injuries (surgery), Humans, Male, Maxillary Sinus Neoplasms (surgery), Middle Aged, Monitoring, Physiologic (instrumentation), Postoperative Care, Prostheses and Implants, Prosthesis Implantation (methods), Regional Blood Flow, Tonsillar Neoplasms (surgery).
- MESH :
- blood supply : Free Tissue Flaps.
- instrumentation : Monitoring, Physiologic.
- methods : Prosthesis Implantation.
- surgery : Carcinoma, Squamous Cell, Hand Injuries, Maxillary Sinus Neoplasms, Tonsillar Neoplasms.
- Aged, Doppler Effect, Humans, Male, Middle Aged, Postoperative Care, Prostheses and Implants, Regional Blood Flow.
Abstract
Postoperative flap monitoring is a vital aspect of free tissue transfer in order to detect early vascular compromise and to enable early flap salvage. The implantable Doppler monitoring system is one of many monitoring devices used to ensure accuracy and reduce unnecessary flap explorations. However, there are a number of concerns with its use, namely tension on the anastomosis, possible vessel constriction and false-negative detection. This study aimed to alleviate these concerns, by introducing a new method of placing the implantable Doppler probe on the adjacent vessel limb of a chimaeric flap. This is illustrated by a case series of chimaeric free tissue flaps that allow this surrogate placement of the Doppler probe.
DOI: 10.1016/j.bjps.2013.10.045
PubMed: 24365566
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">A chimaeric-pattern flap design for implantable Doppler surrogate monitoring: a novel placement technique.</title><author><name sortKey="Kim, Jeong Tae" sort="Kim, Jeong Tae" uniqKey="Kim J" first="Jeong Tae" last="Kim">Jeong Tae Kim</name><affiliation wicri:level="1"><nlm:affiliation>Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, South Korea.</nlm:affiliation><country xml:lang="fr">Corée du Sud</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Ho, Samuel Y M" sort="Ho, Samuel Y M" uniqKey="Ho S" first="Samuel Y M" last="Ho">Samuel Y M. Ho</name><affiliation wicri:level="1"><nlm:affiliation>Section of Plastic and Reconstructive Surgery, Department of General Surgery, Tan Tock Seng Hospital, Singapore, Singapore. Electronic address: lilming2000@gmail.com.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>Section of Plastic and Reconstructive Surgery, Department of General Surgery, Tan Tock Seng Hospital, Singapore</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Youn Hwan" sort="Kim, Youn Hwan" uniqKey="Kim Y" first="Youn Hwan" last="Kim">Youn Hwan Kim</name><affiliation wicri:level="1"><nlm:affiliation>Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, South Korea.</nlm:affiliation><country xml:lang="fr">Corée du Sud</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2014">2014</date><idno type="RBID">pubmed:24365566</idno><idno type="pmid">24365566</idno><idno type="doi">10.1016/j.bjps.2013.10.045</idno><idno type="wicri:Area/PubMed/Corpus">001759</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001759</idno><idno type="wicri:Area/PubMed/Curation">001759</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">001759</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">A chimaeric-pattern flap design for implantable Doppler surrogate monitoring: a novel placement technique.</title><author><name sortKey="Kim, Jeong Tae" sort="Kim, Jeong Tae" uniqKey="Kim J" first="Jeong Tae" last="Kim">Jeong Tae Kim</name><affiliation wicri:level="1"><nlm:affiliation>Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, South Korea.</nlm:affiliation><country xml:lang="fr">Corée du Sud</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul</wicri:regionArea></affiliation></author><author><name sortKey="Ho, Samuel Y M" sort="Ho, Samuel Y M" uniqKey="Ho S" first="Samuel Y M" last="Ho">Samuel Y M. Ho</name><affiliation wicri:level="1"><nlm:affiliation>Section of Plastic and Reconstructive Surgery, Department of General Surgery, Tan Tock Seng Hospital, Singapore, Singapore. Electronic address: lilming2000@gmail.com.</nlm:affiliation><country xml:lang="fr">Singapour</country><wicri:regionArea>Section of Plastic and Reconstructive Surgery, Department of General Surgery, Tan Tock Seng Hospital, Singapore</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Youn Hwan" sort="Kim, Youn Hwan" uniqKey="Kim Y" first="Youn Hwan" last="Kim">Youn Hwan Kim</name><affiliation wicri:level="1"><nlm:affiliation>Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, South Korea.</nlm:affiliation><country xml:lang="fr">Corée du Sud</country><wicri:regionArea>Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul</wicri:regionArea></affiliation></author></analytic><series><title level="j">Journal of plastic, reconstructive & aesthetic surgery : JPRAS</title><idno type="eISSN">1878-0539</idno><imprint><date when="2014" type="published">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Carcinoma, Squamous Cell (surgery)</term><term>Doppler Effect</term><term>Free Tissue Flaps (blood supply)</term><term>Hand Injuries (surgery)</term><term>Humans</term><term>Male</term><term>Maxillary Sinus Neoplasms (surgery)</term><term>Middle Aged</term><term>Monitoring, Physiologic (instrumentation)</term><term>Postoperative Care</term><term>Prostheses and Implants</term><term>Prosthesis Implantation (methods)</term><term>Regional Blood Flow</term><term>Tonsillar Neoplasms (surgery)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Blessures de la main ()</term><term>Carcinome épidermoïde ()</term><term>Débit sanguin régional</term><term>Effet Doppler</term><term>Humains</term><term>Implantation de prothèse ()</term><term>Lambeaux tissulaires libres ()</term><term>Monitorage physiologique (instrumentation)</term><term>Mâle</term><term>Prothèses et implants</term><term>Soins postopératoires</term><term>Sujet âgé</term><term>Tumeurs de l'amygdale ()</term><term>Tumeurs des sinus maxillaires ()</term></keywords><keywords scheme="MESH" qualifier="blood supply" xml:lang="en"><term>Free Tissue Flaps</term></keywords><keywords scheme="MESH" qualifier="instrumentation" xml:lang="en"><term>Monitoring, Physiologic</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Prosthesis Implantation</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Carcinoma, Squamous Cell</term><term>Hand Injuries</term><term>Maxillary Sinus Neoplasms</term><term>Tonsillar Neoplasms</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Doppler Effect</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Postoperative Care</term><term>Prostheses and Implants</term><term>Regional Blood Flow</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Blessures de la main</term><term>Carcinome épidermoïde</term><term>Débit sanguin régional</term><term>Effet Doppler</term><term>Humains</term><term>Implantation de prothèse</term><term>Lambeaux tissulaires libres</term><term>Monitorage physiologique</term><term>Mâle</term><term>Prothèses et implants</term><term>Soins postopératoires</term><term>Sujet âgé</term><term>Tumeurs de l'amygdale</term><term>Tumeurs des sinus maxillaires</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Postoperative flap monitoring is a vital aspect of free tissue transfer in order to detect early vascular compromise and to enable early flap salvage. The implantable Doppler monitoring system is one of many monitoring devices used to ensure accuracy and reduce unnecessary flap explorations. However, there are a number of concerns with its use, namely tension on the anastomosis, possible vessel constriction and false-negative detection. This study aimed to alleviate these concerns, by introducing a new method of placing the implantable Doppler probe on the adjacent vessel limb of a chimaeric flap. This is illustrated by a case series of chimaeric free tissue flaps that allow this surrogate placement of the Doppler probe.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">24365566</PMID><DateCreated><Year>2014</Year><Month>01</Month><Day>27</Day></DateCreated><DateCompleted><Year>2014</Year><Month>03</Month><Day>25</Day></DateCompleted><DateRevised><Year>2014</Year><Month>01</Month><Day>27</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1878-0539</ISSN><JournalIssue CitedMedium="Internet"><Volume>67</Volume><Issue>2</Issue><PubDate><Year>2014</Year><Month>Feb</Month></PubDate></JournalIssue><Title>Journal of plastic, reconstructive & aesthetic surgery : JPRAS</Title><ISOAbbreviation>J Plast Reconstr Aesthet Surg</ISOAbbreviation></Journal><ArticleTitle>A chimaeric-pattern flap design for implantable Doppler surrogate monitoring: a novel placement technique.</ArticleTitle><Pagination><MedlinePgn>190-7</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.bjps.2013.10.045</ELocationID><ELocationID EIdType="pii" ValidYN="Y">S1748-6815(13)00624-4</ELocationID><Abstract><AbstractText Label="INTRODUCTION AND AIM" NlmCategory="OBJECTIVE">Postoperative flap monitoring is a vital aspect of free tissue transfer in order to detect early vascular compromise and to enable early flap salvage. The implantable Doppler monitoring system is one of many monitoring devices used to ensure accuracy and reduce unnecessary flap explorations. However, there are a number of concerns with its use, namely tension on the anastomosis, possible vessel constriction and false-negative detection. This study aimed to alleviate these concerns, by introducing a new method of placing the implantable Doppler probe on the adjacent vessel limb of a chimaeric flap. This is illustrated by a case series of chimaeric free tissue flaps that allow this surrogate placement of the Doppler probe.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">The flap is raised in a chimaeric fashion, with a main perforator pedicle to the skin or muscle paddle for the main reconstructive purpose and a side branch from the main pedicle going to a smaller adipofascial or muscle flap for monitoring. This branch vascular pedicle leading to the chimaeric tissue is kept sufficiently long to enable placement of the Doppler cuff and prevent turbulence. The probe of a Cook-Swartz implantable Doppler system is placed around the branch pedicle, approximately 5 mm from the branching point, and secured with a vessel clip. This is then secured away from the major vessels of the main free flap. Removal of the probe's crystal and wire is easily done with a single gentle traction on postoperative day 7.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Five cases of chimaeric free flaps were performed with this manoeuvre: three thoracodorsal perforator chimaeric flaps for head-and-neck or extremity reconstruction, one latissimus dorsi neuromuscular chimaeric flap for facial reanimation and one digastric lymph node transfer for the treatment of lower limb lymphoedema. The Doppler system showed a low but sustained oscillating flow in all cases indicating vascular patency, with minimal flow interference from other large-calibre vessels. There was no discernible kinking on the anastomosis. There were no complications encountered during probe removal. This postoperative monitoring manoeuvre was done successfully with good results.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">The monitoring equipment is very sensitive to any flow disturbance due to positional changes in the head-and-neck region or the extremities and is able to detect flow changes in buried flaps postoperatively. Chimaeric flap composition is easier now than before because of perforator-oriented pedicle dissection, and surrogate Doppler monitoring is one more application of the chimaeric flap. This novel chimaeric fashion of implantable Doppler probe placement is a good surrogate measure of flow in the main pedicle.</AbstractText><CopyrightInformation>Copyright © 2013. Published by Elsevier Ltd.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Kim</LastName><ForeName>Jeong Tae</ForeName><Initials>JT</Initials><AffiliationInfo><Affiliation>Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, South Korea.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ho</LastName><ForeName>Samuel Y M</ForeName><Initials>SY</Initials><AffiliationInfo><Affiliation>Section of Plastic and Reconstructive Surgery, Department of General Surgery, Tan Tock Seng Hospital, Singapore, Singapore. Electronic address: lilming2000@gmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kim</LastName><ForeName>Youn Hwan</ForeName><Initials>YH</Initials><AffiliationInfo><Affiliation>Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, South Korea.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2013</Year><Month>11</Month><Day>13</Day></ArticleDate></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>J Plast Reconstr Aesthet Surg</MedlineTA><NlmUniqueID>101264239</NlmUniqueID><ISSNLinking>1748-6815</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002294" MajorTopicYN="N">Carcinoma, Squamous Cell</DescriptorName><QualifierName UI="Q000601" MajorTopicYN="N">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004301" MajorTopicYN="N">Doppler Effect</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058752" MajorTopicYN="N">Free Tissue Flaps</DescriptorName><QualifierName UI="Q000098" MajorTopicYN="Y">blood supply</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006230" MajorTopicYN="N">Hand Injuries</DescriptorName><QualifierName UI="Q000601" MajorTopicYN="N">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008444" MajorTopicYN="N">Maxillary Sinus Neoplasms</DescriptorName><QualifierName UI="Q000601" MajorTopicYN="N">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008991" MajorTopicYN="N">Monitoring, Physiologic</DescriptorName><QualifierName UI="Q000295" MajorTopicYN="Y">instrumentation</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011182" MajorTopicYN="N">Postoperative Care</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019736" MajorTopicYN="Y">Prostheses and Implants</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019919" MajorTopicYN="N">Prosthesis Implantation</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012039" MajorTopicYN="N">Regional Blood Flow</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014067" MajorTopicYN="N">Tonsillar Neoplasms</DescriptorName><QualifierName UI="Q000601" MajorTopicYN="N">surgery</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Buried</Keyword><Keyword MajorTopicYN="N">Chimeric</Keyword><Keyword MajorTopicYN="N">Doppler</Keyword><Keyword MajorTopicYN="N">Free flap</Keyword><Keyword MajorTopicYN="N">Implantable</Keyword><Keyword MajorTopicYN="N">Monitoring</Keyword><Keyword MajorTopicYN="N">Perforator</Keyword><Keyword MajorTopicYN="N">TAP</Keyword><Keyword MajorTopicYN="N">TdAP</Keyword><Keyword MajorTopicYN="N">Thoracodorsal artery</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2013</Year><Month>09</Month><Day>11</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2013</Year><Month>10</Month><Day>21</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2013</Year><Month>10</Month><Day>28</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2013</Year><Month>12</Month><Day>25</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2013</Year><Month>12</Month><Day>25</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2014</Year><Month>3</Month><Day>26</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">24365566</ArticleId><ArticleId IdType="pii">S1748-6815(13)00624-4</ArticleId><ArticleId IdType="doi">10.1016/j.bjps.2013.10.045</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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