iDoppler- An Internet-based Doppler Monitoring System
Evan S. Garfein, MD1, Ishaan Dalal, BS2, Adam Charles2, Fred Fontaine, PhD2, Jamie P. Levine, MD1.
1New York University School of Medicine, New York, NY, USA, 2The Cooper Union School of Engineering, New York, NY, USA.
Introduction: Various methods have been described for monitoring microvascular free flaps (MVFFs) in the early post-operative period. The most common is the use of a transcutaneous Doppler device. One of the imperfections of this method of flap monitoring is that, over the critical first 72 hour period, multiple parties will assess the Doppler signal, making serial assessment by a single individual difficult. In addition, most commercially-available devices to not permit recording and time-stamping of the signals to facilitate comparison of signals over time. Lastly, remote interpretation of the signal by the senior surgeon is not possible. This paper describes the engineering of a device to allow the simple acquisition, storage, and retrieval of a Doppler signal via a web-based portal.
Methods: A standard Doppler monitor was connected via a soundcard to a digital recording device. Each recorded file was time-stamped and uploaded into a folder bearing the patient’s medical record number to a password-protected website. Recordings could be annotated at the time of uploading to reflect patient position, temperature, or other, related factors.
Results: Eight patients were monitored via this method during the first twenty four hours of their stay. Each patient had a folder created on the secure site. Hourly Doppler readings were uploaded to the site and could be compared and monitored remotely.
Conclusion: Signal acquisition and remote monitoring of Doppler signals is a valuable tool during post-operative surveillance of microvascular free flaps. It eliminates multi-user bias and permits comparison of signals over time.