Color doppler ultrasonography is a reliable predictor of free tissue transfer outcomes in head and neck reconstruction.

The purpose of our investigation was to report our experience with a color flow doppler (CFD) ultrasonography for postoperative monitoring of free tissue transfers. A retrospective analysis of head and neck free tissue transfers at a single institution between 2000 and 2005 (n = 84; 80 successful, 4 failures). CFD measured blood flow velocity (cm/sec) and resistance to flow in the pedicle vein and artery on postoperative days 1, 3, and 7. Analysis of artery/vein ratio revealed vascular congestion by postoperative day 3 which later resolved. In flap failures, there was a significant reduction (P < 0.05) in venous blood flow by postoperative day 3. Waveform morphology representing vascular resistance and origin of donor flap did not correlate with flap outcome (r(2) = 0.23 and 0.44 respectively). Postoperative monitoring of free tissue transfers may allow for detection of poor perfusion. CFD is an objective method of studying blood flow postoperatively. C-4.