Department of Plastic and Hand Surgery, University of Freiburg Medical Center, Freiburg, Germany.
J Reconstr Microsurg. 2010 May;26(4):265-70. doi: 10.1055/s-0030-1248235. Epub 2010 Feb 8.
Evaluation parameters for free flap monitoring devices are used inconsistently, leading to considerable confusion about the quality and applicability of these devices. A comparison of different systems and different clinical series is almost impossible. The ultimate questions that need to be answered are those regarding the efficiency and the effectiveness of the system. A new tool consisting of two simple parameters that sufficiently and comparably describe the quality of monitoring devices is developed. The flap failure reduction rate describes the percentage of saved flaps (effectiveness). The revision success rate describes the efficiency. Literature reevaluation shows inconsistent results, although all authors describe a positive experience. This shows the limited value of the classical parameters. Larger studies have flap failure reduction rates of 5 to 12% (5 to 12% of monitored flaps are saved). Revision success rates of 75 to 90% prove that the system is efficient enough in daily use. Reevaluation of the smaller reported series result in lower parameters, which shows that there is a significant learning curve for this device. The new parameters alleviate the confusion surrounding evaluation of monitoring systems by giving specific information about effectiveness and efficiency. The benefits of the implanted Doppler probe can now be clearly described. However, in several studies the benefit of the system is overrated.
游离皮瓣监测设备的评估参数使用不一致，导致对这些设备的质量和适用性存在很大的混淆。不同系统和不同临床系列之间的比较几乎是不可能的。最终需要回答的问题是关于系统的效率和有效性。开发了一种由两个简单参数组成的新工具，该工具可以充分且可比地描述监测设备的质量。皮瓣失败减少率描述了保存的皮瓣的百分比（有效性）。修正成功率描述了效率。文献再评估显示结果不一致，尽管所有作者都描述了积极的经验。这表明经典参数的价值有限。较大的研究报告皮瓣失败减少率为 5%至 12%（监测皮瓣中有 5%至 12%得到保存）。修正成功率为 75%至 90%证明该系统在日常使用中效率足够高。对较小的报告系列进行重新评估会得到较低的参数，这表明该设备存在明显的学习曲线。新参数通过提供有关有效性和效率的具体信息，减轻了评估监测系统时的混淆。现在可以清楚地描述植入式多普勒探头的益处。然而，在几项研究中，该系统的益处被高估了。
