Abstract：
Patent microvascular anastomoses are essential for successful free tissue transfer. Early accurate detection of microvascular compromise is required for flap salvage. Adjunctive monitoring techniques, in addition to clinical examination, are increasingly used to detect flap compromise. This systematic review synthesized and appraised the literature to determine the efficacy of different postoperative monitoring technologies. Rates of flap takeback, salvage, failure, and mean time to detection of microvascular compromise were extracted, synthesized, and reviewed. Twenty-two studies were included, comprising 6370 flaps. One thousand three hundred and ninety-five flaps were monitored with Cook Swartz Doppler (21.83%), 1417 flaps with tissue oximetry (22.24%), 291 with laser Doppler (4.56%), 175 with duplex echography (2.74%), 210 with indocyanine green (ICG) fluorescence (3.30%), 196 with Synovis flow coupler (3.07%), and 81 (1.27%) with light spectroscopy. The overall true positive rate for microvascular compromise in taken back flaps was 70.18%. Cook Swartz Doppler (n = 1391) had a true positive rate of 80.17% and 83.63% salvage rate and was associated with an overall 2.60% rate of flap failure. Tissue oximetry (n = 1417) had a true positive rate of 74.76% and a salvage rate of 88.62%. Laser Doppler, duplex echography, light spectroscopy, and Synovis flow coupler demonstrated true positive rates between 69.4% and 100% with salvage rates between 64% and 100%. Cook Swartz Doppler and tissue oximetry are associated with prompt identification of microvascular compromise and return to theatre. Alternative modalities, including near-infrared spectroscopy, laser Doppler, and duplex echography, show promise. Further well-designed randomised controlled trials (RCTs) appraising head-to-head efficacy are required to comparatively assess adjunctive technologies.
摘要：
微血管吻合通畅对于成功的游离组织转移至关重要。皮瓣抢救需要早期准确检测微血管受损。辅助监测技术，除了临床检查，越来越多地用于检测襟翼损坏。本系统综述综合评价了文献，以确定不同术后监测技术的疗效。襟翼收回率,打捞,失败,提取了检测微血管受损的平均时间，合成，并审查。包括22项研究，包括6370个襟翼。用CookSwartz多普勒监测了一千三百九十五个皮瓣(21.83%),1417个组织血氧定量皮瓣（22.24%），291激光多普勒（4.56%），175双回波描记术（2.74％），210具有吲哚菁绿（ICG）荧光（3.30％），196与Synovis流量耦合器（3.07%），和81（1.27％）的光谱。收回皮瓣微血管损害的总体真阳性率为70.18％。CookSwartz多普勒（n=1391）的真实阳性率为80.17％和83.63％的抢救率，并且与总的2.60％的皮瓣失败率相关。组织血氧饱和度（n=1417）的真阳性率为74.76％，挽救率为88.62％。激光多普勒,双工回波描记术,光光谱学,和Synovis流耦合器显示的真阳性率在69.4％至100％之间，抢救率在64％至100％之间。CookSwartz多普勒和组织血氧定量与迅速识别微血管受损并返回手术室有关。替代模式，包括近红外光谱,激光多普勒,和双重回波描记术，显示承诺。需要进一步精心设计的随机对照试验（RCT）来评估头对头的疗效，以比较评估辅助技术。
