A Simplest Method of Flap Monitoring

Over the decades after the introduction of microvascular surgery, free-flap transfer has been one of the options for the reconstruction of soft-tissue defects caused by trauma, cancer resection, and such. The main adverse event of free-flap transfers is vascular complication, leading sometimes to flap loss. With advances in microvascular surgery, methods of flap monitoring have also been developed: surface temperature scanning,[1] implantable or transcutaneous Doppler,[2] [3] [4] blood-flow monitoring with intravenous catheter,[5] transcutaneous laser Doppler,[6] [7] [8] [9] microdialysis,[10] [11] transcutaneous pO₂ monitoring,[12] optical spectroscopy,[13] [14] endscopy,[15] and such. The sensitivity and specificity of these methods are different; however, high sensitivity should be given priority over high specificity for good clinical outcomes. Furthermore, monitoring methods need to be simple, easy to perform, and cost-effective. Here, we propose the simplest and most cost-effective method of flap monitoring.

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