Implantable doppler probes for postoperatively monitoring free flaps: Efficacy. A systematic review and meta-analysis

Tzu Yen Chang, Yao-Chou Lee, You Cheng Lin, Stanley Thian Sze Wong, Yuan-Yu Hsueh, Yao-Lung Kuo, Shyh-Jou Shieh, Jing-Wei Lee

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Although clinical assessment remains the gold standard for monitoring the circulation of free flaps, several adjunct techniques promote timely salvage by detecting circulation compromise early. The objective of this systematic review was to evaluate the efficacy of an implantable Doppler probe for postoperatively monitoring free flaps. Materials and Methods: English-language articles evaluating the efficacy of implantable Doppler probes compared with clinical assessment for postoperatively monitoring free flaps were analyzed. The outcome measures were total flap failure rates, salvage rates, sensitivity, false-positive rates, and positive likelihood ratios. Results: Of the 504 citations identified, 6 comparative studies were included for meta-analysis. An implantable Doppler probe significantly lowered the flap failure rate (risk ratio: 0.40; 95% confidence interval: 0.21-0.75) and raised the successful salvage rate (risk ratio: 1.73; 95% confidence interval: 1.16-2.59). Pooled sensitivity was higher (1.00 vs 0.98), the positive likelihood ratio was lower (72.16 vs 220.48), and the false-positive rate was higher (0.01 vs 0) in the implantable Doppler probe group than in the clinical assessment group. Conclusion: An implantable Doppler probe is significantly more efficacious than clinical assessment for postoperatively monitoring free flaps.

Original languageEnglish
Article numbere1099
JournalPlastic and Reconstructive Surgery - Global Open
Volume4
Issue number11
DOIs
Publication statusPublished - 2016 Jan 1

Fingerprint

Free Tissue Flaps
Meta-Analysis
Odds Ratio
Confidence Intervals
Language
Outcome Assessment (Health Care)

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

@article{8e0a2cdf0f3d41e9ac117b9140412e39,
title = "Implantable doppler probes for postoperatively monitoring free flaps: Efficacy. A systematic review and meta-analysis",
abstract = "Background: Although clinical assessment remains the gold standard for monitoring the circulation of free flaps, several adjunct techniques promote timely salvage by detecting circulation compromise early. The objective of this systematic review was to evaluate the efficacy of an implantable Doppler probe for postoperatively monitoring free flaps. Materials and Methods: English-language articles evaluating the efficacy of implantable Doppler probes compared with clinical assessment for postoperatively monitoring free flaps were analyzed. The outcome measures were total flap failure rates, salvage rates, sensitivity, false-positive rates, and positive likelihood ratios. Results: Of the 504 citations identified, 6 comparative studies were included for meta-analysis. An implantable Doppler probe significantly lowered the flap failure rate (risk ratio: 0.40; 95{\%} confidence interval: 0.21-0.75) and raised the successful salvage rate (risk ratio: 1.73; 95{\%} confidence interval: 1.16-2.59). Pooled sensitivity was higher (1.00 vs 0.98), the positive likelihood ratio was lower (72.16 vs 220.48), and the false-positive rate was higher (0.01 vs 0) in the implantable Doppler probe group than in the clinical assessment group. Conclusion: An implantable Doppler probe is significantly more efficacious than clinical assessment for postoperatively monitoring free flaps.",
author = "Chang, {Tzu Yen} and Yao-Chou Lee and Lin, {You Cheng} and Wong, {Stanley Thian Sze} and Yuan-Yu Hsueh and Yao-Lung Kuo and Shyh-Jou Shieh and Jing-Wei Lee",
year = "2016",
month = "1",
day = "1",
doi = "10.1097/GOX.0000000000001099",
language = "English",
volume = "4",
journal = "Plastic and Reconstructive Surgery - Global Open",
issn = "2169-7574",
publisher = "Lippincott Williams and Wilkins Ltd.",
number = "11",

}

TY - JOUR

T1 - Implantable doppler probes for postoperatively monitoring free flaps

T2 - Efficacy. A systematic review and meta-analysis

AU - Chang, Tzu Yen

AU - Lee, Yao-Chou

AU - Lin, You Cheng

AU - Wong, Stanley Thian Sze

AU - Hsueh, Yuan-Yu

AU - Kuo, Yao-Lung

AU - Shieh, Shyh-Jou

AU - Lee, Jing-Wei

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Background: Although clinical assessment remains the gold standard for monitoring the circulation of free flaps, several adjunct techniques promote timely salvage by detecting circulation compromise early. The objective of this systematic review was to evaluate the efficacy of an implantable Doppler probe for postoperatively monitoring free flaps. Materials and Methods: English-language articles evaluating the efficacy of implantable Doppler probes compared with clinical assessment for postoperatively monitoring free flaps were analyzed. The outcome measures were total flap failure rates, salvage rates, sensitivity, false-positive rates, and positive likelihood ratios. Results: Of the 504 citations identified, 6 comparative studies were included for meta-analysis. An implantable Doppler probe significantly lowered the flap failure rate (risk ratio: 0.40; 95% confidence interval: 0.21-0.75) and raised the successful salvage rate (risk ratio: 1.73; 95% confidence interval: 1.16-2.59). Pooled sensitivity was higher (1.00 vs 0.98), the positive likelihood ratio was lower (72.16 vs 220.48), and the false-positive rate was higher (0.01 vs 0) in the implantable Doppler probe group than in the clinical assessment group. Conclusion: An implantable Doppler probe is significantly more efficacious than clinical assessment for postoperatively monitoring free flaps.

AB - Background: Although clinical assessment remains the gold standard for monitoring the circulation of free flaps, several adjunct techniques promote timely salvage by detecting circulation compromise early. The objective of this systematic review was to evaluate the efficacy of an implantable Doppler probe for postoperatively monitoring free flaps. Materials and Methods: English-language articles evaluating the efficacy of implantable Doppler probes compared with clinical assessment for postoperatively monitoring free flaps were analyzed. The outcome measures were total flap failure rates, salvage rates, sensitivity, false-positive rates, and positive likelihood ratios. Results: Of the 504 citations identified, 6 comparative studies were included for meta-analysis. An implantable Doppler probe significantly lowered the flap failure rate (risk ratio: 0.40; 95% confidence interval: 0.21-0.75) and raised the successful salvage rate (risk ratio: 1.73; 95% confidence interval: 1.16-2.59). Pooled sensitivity was higher (1.00 vs 0.98), the positive likelihood ratio was lower (72.16 vs 220.48), and the false-positive rate was higher (0.01 vs 0) in the implantable Doppler probe group than in the clinical assessment group. Conclusion: An implantable Doppler probe is significantly more efficacious than clinical assessment for postoperatively monitoring free flaps.

UR - http://www.scopus.com/inward/record.url?scp=85048091361&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85048091361&partnerID=8YFLogxK

U2 - 10.1097/GOX.0000000000001099

DO - 10.1097/GOX.0000000000001099

M3 - Article

AN - SCOPUS:85048091361

VL - 4

JO - Plastic and Reconstructive Surgery - Global Open

JF - Plastic and Reconstructive Surgery - Global Open

SN - 2169-7574

IS - 11

M1 - e1099

ER -