Progress of monitoring methods and preventions of disorder of blood supplying of expanded flaps

OBJECTIVE: To summarize the monitoring methods and preventions of the disorder of blood supplying of expanded flaps, so as to provide some references for improving the survival of expanded flaps. METHODS: The domestic and abroad related literature about the disorder of blood supplying of expanded flaps was reviewed and analyzed. RESULTS: Handheld Doppler, digital subtraction angiography, computer tomographic angiography, magnetic resonance angiography, and fluorescein angiography can be used as reliable preoperative imaging methods in designing expanded flaps with rich blood supply. Several techniques can be used for monitoring the blood supply of expanded flaps during the early postoperative period including traditional monitoring via physical examination, monitoring via dynamic infrared thermography, near-infrared spectroscopy tissue oximeter, external and implantable Doppler, and more recently developed diffuse correlation spectroscopy. Surgical delay, bloodletting, leech therapy, hyperbaric oxygen, and so on can decrease the risk of necrosis in expanded flaps. CONCLUSION: The survival of expanded flap is influenced by many factors. Preoperative design by using handheld Doppler and new imaging technology and postoperative early detection of blood supply can provide references of timely intervention, so that ischemic necrosis of the flaps can be reduced, and the success rate of surgery can be improved. 目的: 对扩张皮瓣血运障碍监测方法及防治措施研究进展作一综述，旨在为临床扩张皮瓣血运障碍的防治提供参考。. 方法: 广泛查阅国内外有关扩张皮瓣血运障碍监测及防治的研究文献，并总结分析。. 结果: 术前利用多普勒血流探测仪、数字减影血管造影、计算机断层扫描血管造影术、磁共振血管造影和荧光造影可设计血运丰富的皮瓣，减少术后皮瓣缺血坏死的发生；术后利用红外线热成像、近红外光血氧监测、植入式多普勒等技术监测皮瓣血运，有利于早期发现皮瓣血运障碍，并积极采取挽救措施，如放血、水蛭吸血、血蛭素静脉滴注及高压氧治疗等。. 结论: 扩张皮瓣的成活受多种因素影响，术前利用多普勒血流探测仪及新兴成像技术设计扩张皮瓣、术中术后早期发现扩张皮瓣血运障碍，及时进行干预，可减少扩张皮瓣缺血坏死发生率，提高手术成功率。.

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

Review of monitoring methods and prevention strategies for expanded-flap blood-supply disorders. Bloodletting, leech therapy, and hyperbaric oxygen identified as decongestive interventions to decrease necrosis risk.

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