Modern postoperative monitoring of free flaps

Current Opinion in Otolaryngology & Head and Neck Surgery
Minna KääriäinenJussi Laranne

Abstract

Flap failure in microvascular reconstruction is a costly complication with total flap loss being the worst-case scenario. With the aim to rapidly identify a postoperative circulatory problem, some susceptible flaps can be saved by careful clinical monitoring or by various technical monitoring methods. In head and neck surgery, where the flaps are often buried and difficult to monitor clinically, a reliable technical monitoring method would be useful. A broad range of different techniques are in use varying according to practical and personal preferences among clinics and surgeons. However, no evidence for any particular technique being superb has emerged. We review reports of some frequently used and modern free flap monitoring techniques. Clinical monitoring is still the gold standard to which other techniques are compared to. Laser Doppler flowmetry and near-infrared spectroscopy have been reported to identify early circulatory problems, but both techniques are not well suited for buried flaps. Implantable Doppler, flow coupler, partial tissue oxygen pressure and microdialysis are invasive monitoring methods suitable for buried flaps. More research with practical and clinically relevant parameters, that is flap salvage rate, ...Continue Reading

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Jun 4, 2019·Journal of Surgical Oncology·Ines E TinhoferMing-Huei Cheng
Jul 1, 2020·International Journal of Oral and Maxillofacial Surgery·J T DefermG Meijer
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Apr 7, 2021·Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia·Martin MolitorStefano Lucchina
Sep 21, 2021·Lasers in Surgery and Medicine·Matthäus LinekVeronika Volgger

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