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• W2013376219 abstract "Le développement de la microdialyse in vivo permet d’envisager son application en chirurgie maxillo-faciale, pour le monitorage des lambeaux libres comportant une palette cutanée. Une microsonde est insérée dans le derme du lambeau micro-anastomosé, permettant le recueil d’un dialysat et le dosage des métabolites dermiques : glucose, lactate, pyruvate, glycérol. Les variations des taux sont des marqueurs précoces de la souffrance tissulaire liée à l’ischémie. La surveillance horaire des profils de courbes permet un diagnostic fiable de la thrombose, de son origine artérielle ou veineuse, et donc la reprise des anastomoses avant que les marqueurs cliniques soient altérés. La technique est comparée aux autres moyens validés de surveillance des lambeaux : mesure de la température cutanée, pression transcutanée d’oxygène, laser-Doppler, etc. La microdialyse présente des avantages intéressants : existence de seuils objectifs, différences de profils de courbes selon l’origine artérielle ou veineuse des complications et précocité du diagnostic. L’accessibilité des lambeaux de la cavité buccale ou du pharynx doit faire l’objet d’une évaluation clinique argumentée (fixation de la sonde, site receveur et type du lambeau). The development of in vivo microdialysis has made it possible to monitor cutaneous free flaps in maxillo-facial surgery. A microprobe inserted in the free flap dermis collects a microdialysate enabling measurement of dermal metabolites such as glucose, lactate, pyruvate, or glycerol. The monitoring curves are predictive of ischemia-related tissue injury. Hourly measurements provide a reliable method for early diagnosis of venous or arterial thrombosis. Revision surgery can then be undertaken if needed to repair microanastomoses before clinical alteration. This technique has been compared with validated flaps monitoring systems such as temperature probe, transcutaneous oxygen tension monitoring, and laser Doppler flowmetry. Microdialysis has several advantages: objective measurements, different curves for venous and arterial thrombosis, early diagnosis. Accessibility to oral cavity or pharyngeal flaps requires careful clinical analysis (microprobe fixation, anatomy and choice of flap)." @default.
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• W2013376219 date "2006-01-01" @default.
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• W2013376219 title "Microdialyse et monitorage des lambeaux libres à palette cutanée en chirurgie maxillo-faciale" @default.
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• W2013376219 doi "https://doi.org/10.1016/s0035-1768(06)76978-9" @default.
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