Examining Trends in Implantable Arterial Doppler Usage Among North American Head and Neck Microsurgeons: A Survey Study

Implantable arterial doppler efficacy in free flap reconstruction: A systematic review and meta‐analysis

“…In a previous survey study performed looking at microsurgeon IAD use preferences, a significant majority preferred to use clinical exam as the final adjunct before determining takeback for surgical re‐exploration, despite the doppler's proven record of high accuracy and efficacy 5 . The results of this study provide insight as to why.…”

“…Free flap procedures, let alone repeat operations, are resource‐intense procedures both for hospital systems, providers, and the patient. Therefore, it seems logical that a majority of microsurgeons use it as a screen for compromise and then utilize clinical exams as a final adjunct to determine intervention 5 …”

“…From previous work surveying North American microsurgeons, there is great heterogeneity in protocol which included variances in monitoring duration and surgical re‐exploration criteria 5 . In the interest of evidence‐based medicine, optimal patient outcomes, and reduced healthcare costs, future studies on maximizing implantable doppler efficacy can guide efforts to create a uniform protocol for its use in post‐operative free flap monitoring.…”

“…The efficacy and utility of the IAD is well described. However, a previous survey of microsurgeons displayed a trend in using clinical exams as a final adjunct to determine surgical intervention 5 . The purpose of this current study is to discover the reason implantable dopplers are used as an adjunct to clinical exams despite their established record of accuracy.…”

“…Langenfeld et al found that a significant majority of surveyed North American microsurgeons utilized bedside evaluation prior to making a definitive decision for intervention. Those surveyed recognized the usefulness of the doppler in postprocedure flap monitoring as an important adjunct to the bedside clinical exam 5 . These findings emphasize that although the implantable doppler can provide significant benefit to early detection of vascular flap compromise, routine clinical exam is still required to identify all preliminary signs of possible failure.…”