Postoperative monitoring of skin flaps is subjective and cannot detect early circulatory problems in the flap. Early detection and rapid remedial re-exploration are important for flap salvage. We evaluated flap glucose measurement to monitor the flaps for early detection of circulatory problems. In total, 30 patients underwent cutaneous flap reconstruction. This is an easy, economic, objective, and reliable method for flap monitoring and can detect early venous congestion requiring remedial measures.
MoellhoffNHeidekruegerPIFrankK, et al.Comparing the time-dependent evolution of microcirculation in gracilis vs ALT flaps using laser-Doppler flowmetry and tissue-spectrometry. J Clin Med2022; 11: 2425.
2.
BekaraFHerlinCSomdaS, et al.Free versus perforator-pedicled propeller flaps in lower extremity reconstruction: What is the safest coverage? A meta-analysis. Microsurgery2018; 38: 109–119.
3.
OngAADucicYPipkornP, et al.Implantable Doppler removal after free flap monitoring among head and neck microvascular surgeons. Laryngoscope2022; 132: 554–559.
4.
OuyangSYCaiZGShanXF, et al.Prospective trial of near-infrared spectroscopy for continuous noninvasive monitoring of free fibular flaps. Ann Plast Surg2021; 87: e29–e36.
5.
NordAERojdmarkJWickmanM. Metabolism in pedicled and free TRAM flaps: a comparison using the microdialysis technique. Plast Reconstr Surg2002; 109: 664e73.
6.
TabriziROkhovatpourMAHassaniM, et al.Comparison of single photon emission computed tomography (SPECT) and implantable Doppler in the monitoring of a vascularised fibular free flap for reconstruction of the mandible. Br J Oral Maxillofac Surg2021; 59: 661–664.
7.
RabbaniMJBhattiAZShahzadA. Flap monitoring using thermal imaging camera: a contactless method. J Coll Physicians Surg Pak2021; 30: 703–706.
8.
SalvatoriPParadisiSZaniA. Free flaps monitoring by Laser-Doppler flowmetry in head and neck surgery. Acta Otorhinolaryngol Ital2022; 42: 427–433.
9.
KwasnickiRMNoakesAJBanhidyN, et al.Quantifying the limitations of clinical and technology-based flap monitoring strategies using a systematic thematic analysis. Plast Reconstr Surg Glob Open2021; 9: e3663.
10.
YangQRenZHChickooreeD, et al.The effect of early detection of anterolateral thigh free flap crisis on the salvage success rate, based on 10 years of experience and 1072 flaps. Int J Oral Maxillofac Surg2014; 43: 1059–1063.
11.
WintertonRIPinderRMMorrittAN, et al.Long term study into surgical re-exploration of the ‘free flap in difficulty’. J Plast Reconstr Aesthet Surg2010; 63: 1080–1086.
SakakibaraSHashikawaKOmoriM, et al.A simple method of flap monitoring. J Reconst Microsurg2010; 26: 433–434.
14.
HaraHMiharaMNarushimaM, et al.Possibility of application of metabolomics analysis for supermicrosurgery on children. Acad Collab Sick Child2011; 1: 9–15.
15.
HaraHMiharaMNarushimaM, et al.Flap salvage following postoperative venous thrombosis diagnosed by blood glucose measurement (BGM) in the flaps. ePlasty2011; 11: 28.
16.
MegasIFSimonsDKimBS, et al.Macrophage migration inhibitory factor-an innovative indicator for free flap ischemia after microsurgical reconstruction. Healthcare (Basel)2021; 9: 16.
17.
CreechBMillerS. Evaluation of circulation in skin flaps. In: GrabbWCBert MyersM (eds) Skin flaps. Boston, MA: Lippincott Williams & Wilkins, 1975, pp.21.
18.
MochizukiKMochizukiMGondaK. Flap blood glucose as a sensitive and specific indicator for flap venous congestion: a rodent model study. Plast Reconstr Surg2019; 144: 409e–418e.
