Remote Monitoring of Perforator Flaps Using an Innovative Device with an Application for Mobile Phone: A Pilot Study

Abstract

Surgical technique is considered the most important determining factor in the success of the flap, resulting in an overall complication rate with flap loss risk < 1%. Another important aspect to maintain a high success rate is close monitoring of the flap to identify early variations of the inflow, allowing the possibility of early anastomosis revision surgery, resulting in a more favorable prognosis. 1Multiple methods for flap monitoring have been implemented over time; however, clinical judgment is still the most reliable method.2-8 Other methods used for monitoring perforator flaps are direct thermography, implantable Doppler, external Doppler, microdialysis, infrared oximetry flow, angiography, and images transmitted by electronic devices. These are but a few of the currently designed systems. 4,9-18The aim of this study is to report on a new device for temperature monitoring and its application for mobile telephones. Materials and Methods Design of the DeviceThe 15 Â 10 Â 5 cm device design is shown in ►Fig. 1. The blue liquid-crystal display (LCD) screen and the external characteristics are displayed. Input power transmitter and radiofrequency antenna signal can be observed. The device has an output for the temperature sensor through a 2-m long cable.This device works through a negative temperature coefficient medical grade sensor placed on the skin flap and Keywords ► perforator flaps ► remote monitoring ► mobile device AbstractBackground Surveillance and monitoring of perforator flaps has been well established for many years as a reliable method to detect early changes in the blood flow of the flap. In this manner, early flap revisions could be performed in cases of probable thrombosis. Methods We performed a pilot study that included the first 12 patients to use this device. A temperature sensor electrode was used for remote monitoring of perforator flaps using a mobile phone in real time via a general pocket radio service and short messages developed by the authors, allowing the surgeon to check the temperature from any location. Results The device continually displays the temperature of the flaps in real time performing a curve with measurements every 5 minute using the web page. A significant difference (p < 0.05) is shown between flaps with sufficient flow and flaps with venous thrombosis. Conclusion Real-time direct thermography via the surgeon's mobile phone is a reliable method for flap monitoring, facilitating monitorization during the time when the surgeon is away from the hospital.

Reliability of Postoperative Free Flap Monitoring with a Novel Prediction Model Based on Supervised Machine Learning

“…Some technologies have a long learning curve and require verification with other objective measures by experienced staff. [7][8][9][10][11][12][13][14][15][16][17][18][19] Background: Postoperative free flap monitoring is a critical part of reconstructive microsurgery. Postoperative clinical assessments rely heavily on specialtytrained staff.…”

“…Some technologies have a long learning curve and require verification with other objective measures by experienced staff. 7–19 Direct clinical assessments remain the most convenient and widely accepted clinical practice. 20 Postoperative flap monitoring is labor-intensive and a continuous burden for staff.…”