Evidence map›Paper›PMID 39717710›Full record

ArticleJPRAS open2025

The future of free flap monitoring by laser continuous doppler flowmetry: A prospective assessment in consecutive 71 patients.

Hiroki Kodama, Katsuhiro Ishida, Haruyuki Hirayama, Doruk Orgun, Kazuho Kawashima, Dariush Nikkhah, James May, Panicos A Kyriacou, Takeshi Miyawaki

Abstract read
In one paragraph

Article in JPRAS open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Hiroki KodamaDepartment of Plastic and Reconstructive Surgery, The Jikei University School of Medicine, Tokyo, Japan.
Katsuhiro IshidaDepartment of Plastic and Reconstructive Surgery, The Jikei University School of Medicine, Tokyo, Japan.
Haruyuki HirayamaDepartment of Plastic and Reconstructive Surgery, The Jikei University School of Medicine, Tokyo, Japan.
Doruk OrgunDepartment of Plastic and Reconstructive Surgery, The Jikei University School of Medicine, Tokyo, Japan.
Kazuho KawashimaDivision of Surgery and Interventional Science, University College London, London, United Kingdom.
Dariush NikkhahDivision of Surgery and Interventional Science, University College London, London, United Kingdom.
James MayResearch Centre for Biomedical Engineering, City, University of London, London, United Kingdom.
Panicos A KyriacouResearch Centre for Biomedical Engineering, City, University of London, London, United Kingdom.
Takeshi MiyawakiDepartment of Plastic and Reconstructive Surgery, The Jikei University School of Medicine, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: This study evaluated the effectiveness of laser Doppler flowmetry (LDF) in detecting perfusion disturbances during microvascular free tissue transfer. Methods: Conducted at a single centre from December 2020 to September 2022, this prospective study involved 71 patients mainly undergoing head and neck free flap reconstructions, using the Pocket LDF™ for continuous perfusion monitoring. Results: Out of the 71 cases, data from 69 cases were analysed after excluding those with significant noise or sensor detachment. Blood flow disturbances were observed in 9 cases (13.0 %), with 5 of these cases with a history of surgery or radiation in the same area. There were 5 cases of ischaemia, 4 of which occurred during monitoring. There were 4 cases of venous congestion, with 1 occurring during monitoring. Re-operation was necessary in 8 cases (11.6 %), involving flap replacements, vascular re-anastomoses and hematoma evacuation. Complete flap necrosis occurred in 5 cases (7.2 %) and partial necrosis occurred in 3 cases (4.3 %). The LDF device demonstrated the ability to identify perfusion issues hours before the clinical symptoms manifested, suggesting its potential for early intervention. However, challenges included maintaining continuous monitoring immediately post-surgery and during patient transfers. Conclusion: LDF is a valuable, non-invasive tool for early detection of perfusion disturbances in free flap procedures. It provides continuous, real-time feedback on microcirculation, facilitating timely interventions. Despite its benefits, enhancements in sensor adhesion and wireless technology are needed to improve monitoring reliability. Further studies are recommended to refine LDF usage and validate its efficacy in various clinical settings.

Indexed as

Early detectionFree flapHead and neck reconstructionLaser Doppler flowmetryMicrocirculationNon-invasive monitoringPerfusion monitoringVascular complications

Identifiers

PMID39717710
PMCPMC11665381

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