Monitoring of Myocutaneous Flaps by Measuring Capillary Glucose and Lactate Levels

Garcı́a-Dorado, David; Moris, Vivien; Cristofari, S.; Gerenton, Brice; Anna, Hallier; Rizzi, Philippe; Henault, B.; Zwetyenga, N.

doi:10.1097/sap.0000000000001313

Cited by 5 publications

(2 citation statements)

References 13 publications

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“…35 Smaller studies (with limited follow-up investigation) have also investigated continuous tissue perfusion monitoring that display photoplethysmograph waveforms on a bedside monitor, 36 technetium-99m sestamibi scintigraphy, 37 perfusion-weighted magnetic resonance imaging (MRI), 38 and serial measurement of the flap's capillary glucose and lactate levels. 39 While many of these potential options have relatively low cost and side-effect profiles, all of them require additional investigation (larger trials, randomized head-to-head comparisons, and cost analyses) to determine whether or not they truly provide any additional benefit over the traditional monitoring techniques discussed previously.…”

Section: Other Optionsmentioning

confidence: 99%

Postoperative Free-Flap Monitoring Techniques

Kohlert

Quimby

Saman³

et al. 2019

Seminars in Plastic Surgery

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Section: Other Optionsmentioning

confidence: 99%

Postoperative Free-Flap Monitoring Techniques

Kohlert

Quimby

Saman³

et al. 2019

Seminars in Plastic Surgery

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“…However, it is widely known that flap blood glucose levels decrease when flap ischemia or congestion occurs due to an anastomotic thrombus. [7][8][9][10][11][12] Currently, it is common that flap blood glucose monitoring be performed manually every few hours; however, automatic and continuous monitoring is not commonly performed.…”

Section: Introductionmentioning

confidence: 99%

Flap Monitoring Using Interstitial Fluid Glucose Measurements

et al. 2022

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Background: Various flap monitoring techniques have been used in the early detection of anastomotic thrombus; however, the use of automatic and continuous monitoring methods is presently uncommon. The purpose of this study was to investigate trends in interstitial fluid glucose concentration (IFG) in flap monitoring by measuring IFG automatically and continuously. Methods: Nine patients underwent unilateral breast reconstruction using a transverse rectus abdominis myocutaneous flap with vascular anastomosis. Two IFG measuring devices were attached to each patient. One device was attached to the flap (flap IFG) and the other to the healthy breast (control IFG). In each case, flap IFG, control IFG, and IFG ratio (flap IFG/control IFG) were recorded in the initial 72 h post-surgery (first half) and also in the subsequent 72 h (second half). In all of the cases, the mean values recorded in the first half and those in the second half were compared. Results: All flaps survived. The flap IFG didn’t fall below 40 mg/dL in the first half. The minimum flap IFG and IFG ratio were 42 mg/dL and 0.55 in the first half. The flap IFG was significantly higher in the first half than in the second half in all cases, and the IFG ratio was similar in 8 cases. Furthermore, mean flap IFG and mean IFG ratio in all cases in the first half were significantly higher than in the second half. Conclusions: IFG measurements may complement conventional flap monitoring, particularly in the early postoperative period.

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