Techniques of Monitoring Buried Fasciocutaneous Free Flaps

Abstract

Temporarily externalizing a segment of tissue is an easy and reliable method for monitoring a buried fasciocutaneous free flap. It is important, however, to avoid obstruction at the perforator level beyond the common source vessels.

Evidence to Support Controversy in Microsurgery

“…177 Often, implantable Doppler systems represent the only available form of monitoring in buried flaps, although some authors have reported success with temporarily externalizing implanted flaps (Level V Evidence). 178 Kind et al demonstrated in a series of 147 flaps the implantable Doppler was able to salvage 100 percent of flap take-backs (Level IV Evidence). 179 In a study of 103 patients undergoing 121 microvascular anastomoses, the negative predictive value of the implantable Doppler study system was 100 percent (Level IV Evidence).…”

Advances in free flap monitoring: have we gone too far?

“…Ferguson and Yu [10 ] do recommend that care should be taken not to strangulate the perforator to the externalized component during the placement of this externalized segment.…”

“…Ferguson and Yu [10 ] describe their technique for monitoring buried flaps. They present a case series of 94 free flaps, most of which were anterolateral thigh flaps, used in laryngotracheal and pharyngeal reconstruction.…”

Das postoperative Monitoring von (frei) vaskularisierten Knochentransplantaten zur Rekonstruktion von Knochendefekten

“…Die Autoren glauben jedoch, dass der Nutzen der klinisch einfach umsetzbaren und nicht teuren Hautinsel auch eine sekundäre Entfernungin Lokalanästhesie -rechtfertigt. Sie ermöglicht eine kontinuierliche und für das medizinische Fachpersonal leicht durchführbare Möglichkeit zur Beurteilung der Durchblutung des Transplantates [17]. Zu bedenken bleibt, dass eine Torsion oder Druck auf die Gefäßpedikel der Hautinsel, z.…”