Abstract
Postoperative assessment of vascular surgical reconstructive procedures is most commonly performed by means of Doppler flowmetry or manual pulse palpation. Because these techniques are intermittent and can be subjective, the authors have investigated the application of a piezoelectric pulse sensor in monitoring distal pulses continuously in patients undergoing limb revascularization. By placing a piezoelectric sensor on the skin overlying an artery, systolic displacement of the underlying vessel wall and tissue is converted into a graphically displayed real-time waveform. Hardcopies of the waveforms (n = 90) were obtained at hourly postoperative intervals from a total of 10 patients undergoing vascular surgery for occlusive disease.
In all cases, continuous monitoring confirmed ongoing patency of the reconstructions, despite impalpable distal pulses in 60% of the patients. The amplitudes of the waveforms increased (mean = 18%, range = 6% to 33%) during the first eight postoperative hours. Because of the small size and sensitivity of the sensor, this technique was especially useful in patients with foot lesions requiring occlusive dressings, or where sequential stenoses prevented accurate assessment of postoperative circulation by manual palpation or Doppler examination.
The authors conclude that continuous postoperative piezoelectric pulse monitoring allows accurate, continuous assessment of limb revascularization and alleviates the subjective, time-consuming observations by physicians and ancillary personnel.
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