Knoedler, Samuel and Hoch, Cosima C. and Huelsboemer, Lioba and Knoedler, Leonard and Stoegner, Viola A. and Pomahac, Bohdan and Kauke-Navarro, Martin and Colen, David (2023) Postoperative free flap monitoring in reconstructive surgery-man or machine? FRONTIERS IN SURGERY, 10: 1130566. ISSN 2296-875X,
Full text not available from this repository. (Request a copy)Abstract
Free tissue transfer is widely used for the reconstruction of complex tissue defects. The survival of free flaps depends on the patency and integrity of the microvascular anastomosis. Accordingly, the early detection of vascular comprise and prompt intervention are indispensable to increase flap survival rates. Such monitoring strategies are commonly integrated into the perioperative algorithm, with clinical examination still being considered the gold standard for routine free flap monitoring. Despite its widespread acceptance as state of the art, the clinical examination also has its pitfalls, such as the limited applicability in buried flaps and the risk of poor interrater agreement due to inconsistent flap (failure) appearances. To compensate for these shortcomings, a plethora of alternative monitoring tools have been proposed in recent years, each of them with inherent strengths and limitations. Given the ongoing demographic change, the number of older patients requiring free flap reconstruction, e.g., after cancer resection, is rising. Yet, age-related morphologic changes may complicate the free flap evaluation in elderly patients and delay the prompt detection of clinical signs of flap compromise. In this review, we provide an overview of currently available and employed methods for free flap monitoring, with a special focus on elderly patients and how senescence may impact standard free flap monitoring strategies.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | LASER-DOPPLER FLOWMETRY; NEAR-INFRARED SPECTROSCOPY; FREE TISSUE TRANSFER; COOK-SWARTZ DOPPLER; COLOR DUPLEX SONOGRAPHY; FLOW COUPLER; COST-EFFECTIVENESS; BLOOD-FLOW; HEAD; EXPERIENCE; flap monitoring; free tissue transfer; microvascular reconstruction; microsurgery; free flap; reconstructive surgery |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Plastische-, Hand- und Wiederherstellungschirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 14 May 2024 12:54 |
| Last Modified: | 15 May 2024 04:16 |
| URI: | https://pred.uni-regensburg.de/id/eprint/59887 |
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