Use of colour duplex Doppler imaging in the postoperative assessment of buried free flaps

The postoperative assessment of free flaps is essential to identify and act on signs of incipient flap failure. Where the flap is completely buried, t his becomes almost impossible unless part of the flap is exteriorised or an overlying skin window is used. Alternatively, complicated and often imprac tical monitoring devices have been advocated, but these have failed to gain widespread acceptance. A simpler solution to this problem has been evaluat ed in a series of patients using colour duplex Doppler imaging. This re-app raisal of a previously reported technique has been facilitated by updated t echnology in diagnostic radiology. Duplex Doppler imaging was confirmed as an accurate, non-invasive, and inexpensive tool for the postoperative measu rement of blood flow within the pedicles of five buried free flaps in four patients undergoing surgery in our unit. (C) 2001 Wiley-Liss, Inc.