Abstract：
The implantable arterial doppler (IAD) is frequently used to postoperatively monitor free flaps with high accuracy, but there are no guidelines for its use. Bedside exam is used adjunctively to determine necessary intervention. This systematic review seeks to discover why the doppler is used adjunctively despite its established record of accuracy. Criteria for inclusion and exclusion were established. In total, 280 articles were found on PubMed and Web of Science, then screened accordingly. Data from 22 articles were analyzed using a bivariate hierarchical random effects model. Twenty-two studies yielded 2996 total patients undergoing 3127 free flap procedures. The meta-analysis found a high sensitivity of 0.809 (95% CI = 0.709, 0.880) and specificity of 0.966 (95% CI = 0.947, 0.979). False-positive rate was found to be 0.034 (95% CI = 0.021, 0.053). Positive and negative predictive values were 0.711 (95% CI = 0.581, 0.817) and 0.979 (95% CI = 0.966, 0.988). Positive and negative likelihood ratios were 24.7 (95% CI = 14.5, 39.5) and 0.20 (95% CI = 0.12, 0.30). The established efficacy of the IAD is supported by this study. Clinical exams may remain as the final adjunct due to the risks of inaccurate IAD signals. Further studies are warranted to optimize its use for future practice guidelines.
摘要：
植入式动脉多普勒（IAD）经常用于高精度的术后监测游离皮瓣，但是没有使用指南。床边检查用于辅助确定必要的干预。这篇系统的综述旨在发现为什么尽管多普勒已经建立了准确性记录，但仍要辅助使用多普勒。确定了纳入和排除的标准。总的来说,在PubMed和WebofScience上找到了280篇文章，然后进行相应的筛选。使用双变量分层随机效应模型分析了来自22篇文章的数据。22项研究共获得2996例接受3127例游离皮瓣手术的患者。荟萃分析发现，敏感性为0.809（95％CI=0.709，0.880），特异性为0.966（95％CI=0.947，0.979）。假阳性率为0.034(95%CI=0.021,0.053)。阳性和阴性预测值分别为0.711（95％CI=0.581，0.817）和0.979（95％CI=0.966，0.988）。阳性和阴性似然比分别为24.7（95％CI=14.5，39.5）和0.20（95％CI=0.12，0.30）。本研究支持IAD的既定功效。由于IAD信号不准确的风险，临床检查可能仍然是最终的辅助手段。有必要进行进一步的研究，以优化其在未来实践指南中的使用。
