Akutmonitoring bei Lappenplastiken mittels Laser-Doppler-Flussmessung in Kombination mit einem Lagewechseltest
With the help of Laser Doppler flowmetry (LDF), fifteen patients with skin grafting on different skin areas were tested with the transposition test for post-operative vitality control and for observation of microcirculatory changes depending on position. The instrument used was a LDF-monitor DRT4 by Moor Instruments Ltd. During the transposition test, the bed was turned about 30°, so the patient, while lying in bed, was put into a head position and then in a foot-down position. Analogous to the orthostatic changes (monitored area under heart level: slowdown of the blood flow; monitored area above heart level: initial acceleration of the blood flow), there were expected changes in the measured flux. After dividing the patients into groups according to the localisation of their grafts, 22% (11 out of 50) of the patients with grafts at the lower extremities showed such regularity. This was not the case with the patients with other graft localisation such as in head, arm and chest areas. The measurements for the vitality control were made immediately after the surgery, one hour later and on the 1st, 2nd, 3rd, 4th, 5th, 6th, 7th, 10th, 14th and 21st post operative day. According to our results, the LDF measurements do not contribute to the diagnostic investigation of a vascular obliteration for further differentiation of an arterial or venous thrombus. The fixation of the probe holder is the requirement for the vitality test with the use of acute monitoring (which is a discontinuous monitoring) to ensure reliable measurements. It would be more recommendable to use continuous monitoring which allows observing any changes in the measured area on a continuous basis, thus a worsening of the blood flow can be detected at an early stage.
info:eu-repo/classification/ddc/610, Medizin, Laser-Doppler, Akutmonitoring, Lappenplastiken
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