Bimodal diagnosis of venous congestion in skin flaps after facelift: data of laser Doppler flowmetry and optical coherence tomography angiography

Objective. To identify early signs of venous congestion in facial flaps after facelift using laser Doppler flowmetry (LDF) and optical coherence tomography angiography (OCTA). Material and methods. The study included 74 lateral facial flaps from 37 patients who underwent facelift surgery. Blood circulation in flaps with venous congestion (n=7) and flaps without complications (n=67) was studied using OCTA and LDF after 2 and 7 postoperative days. Results. According to LDF, microcirculation index (MI) changes were codirectional, but differed in intensity. In flaps with venous congestion, MI increased faster and exceeded preoperative value by 53% after 7 days. OCTA signs of venous congestion in flaps were associated with reduced overall density of vascular network. The peculiarity of LDF in diagnosis of venous congestion in a flap is high sensitivity (86%), but relatively low specificity (42%). Conclusion. The advantage of combination of both methods (laser Doppler flowmetry and optical coherence tomography angiography) is higher specificity of diagnosis of venous congestion in flaps (78%) with high sensitivity.