Color Doppler ultrasound for monitoring free flaps in the head and neck region.

The use of microvascular free flaps has become established as a very reliable reconstructive technique following tumor surgery or trauma in the head and neck region. Occasionally, flap compromise may occur which will require immediate re-exploration. Early diagnosis of vascular insufficiency is essential. Clinical signs are not always reliable. Numerous systems have been described for monitoring the viability of microsurgical free flaps. The authors consider that color Doppler ultrasound is one of the most useful diagnostic tools. Three cases are reviewed in which this technique aided the decision whether re-exploration was necessary.