Tissue pH Monitoring in Microsurgery: A Preliminary Evaluation of Continuous Tissue pH Monitoring As an Indicator of Perfusion Disturbances in Microvascular Free Flaps

Free flap monitoring using simultaneous non-invasive laser Doppler flowmetry and tissue spectrophotometry

“…Multiple methods of flap monitoring have been developed in an attempt to find one that is objective, easy to use, valid and reproducible. The most common methods are laser Doppler flowmetry (Jones and Greenhalgh, 1983;Tsuzuki et al, 1990;Place et al, 1996;Yoshino et al, 1996;Yuen and Feng, 2000), plethysmography (Harrison and Mott, 1989), tissue pH monitoring (Raskin et al, 1983;Warner et al, 1989), transcutaneous oxygen monitoring (Smith et al, 1983;Katsaros et al, 1985;Wolff et al, 1996;Pickett et al, 2003;Schultze-Mosgau et al, 2003), intravenous sodium fluorescein monitoring (Silverman et al, 1980), temperature monitoring (Kaye, 1987), tissue oxygen tension (Liss and Liss, 2000;Kamolz et al, 2002) and others.…”

Modern adjuncts and technologies in microsurgery: An historical and evidence‐based review

“…Recent techniques reported for postoperative monitoring include pulse oximetry,79–91 perfusion photoplethysmography,92, 93 surface temperature measurement,94, 95 fluorometry,95–102 microdialysis,103–106 ultrasound,79, 107–109 implanted (Cook‐Swartz) Doppler probes (see Fig. 2),110–119 laser Doppler flowmetry,120–126 impedance plethysmography,127–129 confocal microscopy,130 nuclear medicine,131–133 subcutaneous pH measurement,95, 134–136 hydrogen clearance,137, 138 externalization of part of a buried flap,122, 139 and white light spectrometry 123…”

13 Postoperative Care and Management of Surgical Complications

“…1,2 Our recommendation for flap monitoring is shown in Numerous methods have been described for flap monitoring. 3,4,5,6,7,8,9,10 Clinical observation of a visible free flap is the gold standard method against which other monitoring systems are generally measured. However, even the most experienced observer may have difficulty in assessing certain flaps, and monitoring systems are of significant value in these situations and in the assessment of buried flaps.…”