Standardized Skin Flap Warming Effectively Improves Flap Survival without Obstructing Temperature Monitoring after DIEP

Abstract

Objective: This study aimed to determine whether skin flap warming after an operation interferes with temperature monitoring. The postoperative nursing workflow of subabdominal deep inferior epigastric artery perforator (DIEP) flap breast reconstruction was optimized. Methods: A retrospective analysis involving 69 patients who received one-stage breast reconstruction at the Huashan Hospital from July 2017 to December 2019 was performed. The postoperative physical care of patients, including flap temperature monitoring and flap warming, was reviewed. Results: All patients had successful operations. After surgery, all flaps were warmed following the standard protocol. Abnormal temperature and compromised circulation of flaps were observed in three of the patients. These patients received re-exploration surgery and all three flaps survived. A postoperative follow-up shows a high level of patient satisfaction in most cases. Conclusions: The appropriate warming of transplanted flaps did not interfere with temperature monitoring. This helped determine whether there was compromised circulation, leading to increased skin flap survival and improved patient satisfaction.

Towards Optimizing Sub-Normothermic Machine Perfusion in Fasciocutaneous Flaps: A Large Animal Study

“…Using ICG for such ex vivo flap perfusions could permit better monitoring of skin perfusion. Another point is the temperature, which was set as subnormothermic (19-21 • C) and could have influenced the flap's micro-vascularization [54]. Normothermic perfusion could improve the skin paddle's vascularization.…”