Implantable Doppler in monitoring free flaps: A cost-effectiveness analysis based on a systematic review of the literature

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• 作者：T.G. Poder^a ; ^b ; ^{tpoder.chus@ssss.gouv.qc.ca} ; P.-H. Fortier^c
• 关键词：Doppler ; Implantable ; Cost ; Effectiveness ; Vascularisation ; Free flap
• 刊名：European Annals of Otorhinolaryngology, Head and Neck Diseases
• 出版年：2013
• 出版时间：April, 2013
• 年：2013
• 卷：130
• 期：2
• 页码：79-85
• 全文大小：348 K

文摘

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Summary

Objective

The purpose of this paper is to evaluate the efficacy and cost-effectiveness of the implantable Doppler system based on the analysis of the available scientific literature and clinical and cost data available in our hospital. The results of this system are compared to those of conventional free flap monitoring methods.

Materials and methods

The literature published between 1991 and 2011 was systematically reviewed. All available cost data were collected and several simulations were performed. A retrospective assessment of the efficacy of conventional methods in our hospital was also conducted.

Results and conclusion

The implantable Doppler system is more effective than the conventional methods used to monitor free flap perfusion. The mean flap salvage rate with the implantable Doppler was 21 percentage points higher (81.4 vs. 60.4). The excess cost compared to conventional methods was about CAD 120 per patient (about EUR 94). However, this excess cost can be compensated or even reversed, depending on the initial flap salvage rate in the health facility and the type of free flap (buried vs. non-buried).