New prospects in postoperative free flap monitoring

Introduction: Reconstruction using free flaps has become a reliable technique. Nevertheless, pedicle thrombosis is dreaded, and the earlier diagnosis of such complications is made, the higher surgical salvage rate is.

Clinical monitoring remains the most useful but makes late and unreliable diagnosis. Numerous studies aimed to find ideal monitoring techniques for free flaps. Actually the most efficient ones often deal with expensive and invasive technics.

In this study, authors suggest an efficient, simple, cheap technique to detect arterial or vein thrombosis after free flaps vessels anastomosis.

Materials and methods: In this multicentric prospective study capillary blood glucose and lactate measurements were done. These parameters were compared with standardized clinical monitoring during the five first postoperative days. Clinical and biochemical data have been studied in eventful versus uneventful postoperative recoveries. Calculation of biological thresholds was done to predict eventually artery or venous thrombosis of the free flap’s pedicle.

Results: This multicentric prospective study shows first results of free flap monitoring using capillary blood glucose and lactate measurements. Biochemical events occur six hours earlier than clinical symptoms. No complication imputable to the technique had been noticed. Cost of five days monitoring is about 70 dollars. Neither false negative nor false positive case was found.

Discussion: Capillary measurement using biochemical parameters is a reliable method for early detection of free flap pedicle thrombosis. The simplicity and efficiency of this technique may lead to a wide application.

Conflict of interest: None declared.

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Feb 5, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on New prospects in postoperative free flap monitoring
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