American Society of Hirudotherapy

Monitoring free flaps with Cook-Swartz implantable Doppler probe in head-and-neck reconstruction

Research article published in European annals of otorhinolaryngology, head and neck diseases (2025)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Research reportClinical LiteratureCervini et al. · European annals of otorhinolaryngology, head and neck diseases, 2026

Abstract

Postoperative monitoring of free flaps has traditionally been based on clinical assessment, interpretation of which may be subjective. The Cook-Swartz implantable Doppler probe enables continuous objective real-time monitoring of blood flow at microvascular anastomoses. We report our experience with a cohort of 181 consecutive patients operated on between 2019 and 2025. Arterial placement of the probe was preferred after an initial experience of venous monitoring, and provided a clear and easily interpretable signal. The device demonstrated excellent diagnostic accuracy, with a positive predictive value of 100% for the detection of vascular anomalies. However, early detection does not always guarantee flap salvage. Clinical examination remains indispensable, particularly for detecting venous thromboses that may be overlooked on arterial monitoring alone. The Cook-Swartz implantable Doppler system is a reliable easy-to-use adjunct to clinical monitoring of free flaps in head and neck reconstruction.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal Article
Indexed MeSH termsHumansFree Tissue FlapsHead and Neck NeoplasmsPlastic Surgery ProceduresUltrasonography, DopplerFemaleMaleAnastomosis, SurgicalMonitoring, Physiologic

Summary

This cohort study of 181 consecutive head and neck free flap patients found that arterial placement of the Cook-Swartz implantable Doppler probe provided a 100% positive predictive value for detecting vascular anomalies. Clinical examination remains indispensable for detecting venous thromboses.

Why This Matters for Hirudotherapy

This report describes experience with the Cook-Swartz implantable Doppler probe for postoperative monitoring in 181 consecutive head and neck free flap reconstructions (2019–2025), finding excellent diagnostic accuracy with 100% positive predictive value for vascular anomaly detection using arterial probe placement, while noting that clinical examination remains essential for detecting venous thromboses. Free flap reconstruction with risk of venous thrombosis represents a clinical context where leech therapy may be employed for congestion salvage. However, the study does not address leech use, flap salvage methods, or hirudotherapy outcomes; it focuses exclusively on monitoring technology.

Citation

Reference (Vancouver style)

Cervini MM, Nguyen DH, Haroun F, Deneuve S, Mirghani H. Monitoring free flaps with Cook-Swartz implantable Doppler probe in head-and-neck reconstruction. Eur Ann Otorhinolaryngol Head Neck Dis. 2026;143(3):230-233. doi:10.1016/j.anorl.2025.10.009. PMID: 41173770

Bibliographic details (authors, volume, pages, DOI) are taken from the PubMed record.

DOIPubMed

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