Hallock G G, Koch T J
Dorothy Rider Pool Microsurgery and Laser Laboratory, Allentown Hospital, PA.
Ann Plast Surg. 1990 Mar;24(3):213-5. doi: 10.1097/00000637-199003000-00004.
Any buried free tissue transfer presents a dilemma for postoperative monitoring, and the vascularized jejunum as used for head and neck reconstruction is no exception. Exteriorization of a small common segment of the jejunum in a sense permits direct visualization. Objective assessment may then simultaneously be possible with a harmless external probe sewn onto the serosa. The laser Doppler blood perfusion monitor as one such device provides a simple means for continuous analysis of the adequacy of the jejunal circulation. Intraperitoneal in situ monitoring of isolated island jejunal segments has shown significant, immediate alteration of flow regardless of whether the vein or artery has been occluded. The laser Doppler has also proved accurate after transfer in predicting impending flap failure even though peristalsis and serosal color appeared normal on direct inspection.
任何埋藏式游离组织移植在术后监测方面都存在难题，用于头颈部重建的带血管空肠也不例外。在某种意义上，将一小段空肠外置可实现直接可视化。然后，通过将一个无害的外部探头缝在浆膜上，有可能同时进行客观评估。激光多普勒血流灌注监测仪就是这样一种设备，它为持续分析空肠循环的充足性提供了一种简单方法。对孤立的岛状空肠段进行腹腔内原位监测表明，无论静脉或动脉是否被阻断，血流都会立即发生显著变化。即使在直接检查时蠕动和浆膜颜色看起来正常，激光多普勒在移植后也已被证明能准确预测即将发生的皮瓣坏死。
