Deciphering the Sensitivity and Specificity of the Implantable Doppler Probe in Free Flap Monitoring.
Research article published in Plastic and reconstructive surgery (2016)
Abstract
BACKGROUND: The efficacy of implantable Doppler probes remains an area of considerable debate. This study aims to decipher its sensitivity and specificity for free flap monitoring. METHODS: A retrospective review of all free flaps with an implantable Doppler probe was performed between 2000 and 2012. RESULTS: A Cook-Swartz implantable Doppler probe was used in 439 patients (head and neck, n = 364; breast, n = 53; extremity, n = 22), and demonstrated equivalent sensitivity and specificity between flap types. The overall sensitivity and specificity were 77.8 percent and 88.4 percent, respectively. The artery was monitored in 267 patients, compared to venous monitoring in 101 patients, and in 71 patients both the artery and vein were monitored. Arterial monitoring had significantly greater specificity than venous monitoring, (94.2 percent versus 74.0 percent; p < 0.001), but no benefit was found in monitoring both the artery and the vein. Venous monitoring was significantly associated with reoperation (OR, 3.17; 95 percent CI, 1.70 to 5.91; p = 0.0003). There were 284 flaps that had a monitoring segment in addition to the implantable Doppler probe that significantly increased overall specificity for microvascular complications (OR, 17.71; 95 percent CI, 3.39 to 92.23; p = 0.0006). The specificity (90.5 percent versus 84.8 percent) and sensitivity (80.0 percent versus 66.7 percent) were significantly higher for clinically monitored flaps. The take-back rate was 13.0 percent, with positive findings in 59.6 percent, and 5.2 percent total flap loss. CONCLUSIONS: The use of implantable Doppler probes has high sensitivity and specificity for buried free flaps despite positive findings in less than 60 percent of take-backs. Monitoring the artery is recommended, but clinical examination remains the gold standard for flap monitoring. CLINICAL QUESTION/LEVEL OF EVIDENCE: Diagnostic, IV.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
The efficacy of implantable Doppler probes remains an area of considerable debate. This study aims to decipher its sensitivity and specificity for free flap monitoring.
Por qué esto importa para la hirudoterapia
This study evaluated the sensitivity and specificity of implantable Doppler probes for monitoring free tissue flaps in 439 patients, finding high overall accuracy but recommending arterial monitoring and clinical examination as the gold standard. Its relevance to ASH is indirect: leech therapy is sometimes used in salvage of compromised flaps and venous congestion episodes, so improved flap monitoring could theoretically guide when adjunctive hirudotherapy might be deployed. However, the article does not mention leeches, hirudotherapy, or venous congestion management at any point. The connection is contextual only, and the study offers no data on leech therapy outcomes.
Citación
Deciphering the Sensitivity and Specificity of the Implantable Doppler Probe in Free Flap Monitoring.
Chang et al. · Plastic and reconstructive surgery, 2016
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 28, 2026 · Última actualización del sitio: June 18, 2026