ABSTRACT
Evaluation parameters for free flap monitoring devices are used inconsistently, leading
to considerable confusion about the quality and applicability of these devices. A
comparison of different systems and different clinical series is almost impossible.
The ultimate questions that need to be answered are those regarding the efficiency
and the effectiveness of the system. A new tool consisting of two simple parameters
that sufficiently and comparably describe the quality of monitoring devices is developed.
The flap failure reduction rate describes the percentage of saved flaps (effectiveness).
The revision success rate describes the efficiency. Literature reevaluation shows
inconsistent results, although all authors describe a positive experience. This shows
the limited value of the classical parameters. Larger studies have flap failure reduction
rates of 5 to 12% (5 to 12% of monitored flaps are saved). Revision success rates
of 75 to 90% prove that the system is efficient enough in daily use. Reevaluation
of the smaller reported series result in lower parameters, which shows that there
is a significant learning curve for this device. The new parameters alleviate the
confusion surrounding evaluation of monitoring systems by giving specific information
about effectiveness and efficiency. The benefits of the implanted Doppler probe can
now be clearly described. However, in several studies the benefit of the system is
overrated.
KEYWORDS
Monitoring - free flaps - Doppler probe
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Niklas IblherM.D.
Department of Plastic and Hand Surgery, University of Freiburg Medical Center
Hugstetterstrasse 55, 79106 Freiburg, Germany
Email: niklas.iblher@uniklinik-freiburg.de
