Current Evidence for Postoperative Monitoring of Microvascular Free Flaps: A Systematic Review

Annals of Plastic Surgery

Volumn 74, Issue 5, 2015, Pages 621-632

  Chae, Michael P ^a   Rozen, Warren Matthew ^a   Whitaker, Iain S ^b   Chubb, Daniel ^c   Grinsell, Damien ^c   Ashton, Mark W ^c   Hunter Smith, David J ^a   Lineaweaver, William C ^d  

^a FRANKSTON HOSPITAL   (Australia)

^b SWANSEA UNIVERSITY   (United Kingdom)

^c UNIVERSITY OF MELBOURNE   (Australia)

^d Joseph M Still Burn and Reconstructive Center   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

BODY TEMPERATURE; DOPPLER FLOWMETRY; FLUOROMETRY; FREE TISSUE GRAFT; GRAFT SURVIVAL; HUMAN; MICRODIALYSIS; MOBILE APPLICATION; NEAR INFRARED SPECTROSCOPY; OXIMETRY; PHOTOELECTRIC PLETHYSMOGRAPHY; PHOTOGRAPHY; PHYSIOLOGIC MONITORING; POSTOPERATIVE CARE; PROCEDURES; VASCULARIZATION;

BODY TEMPERATURE; FLUOROMETRY; FREE TISSUE FLAPS; GRAFT SURVIVAL; HUMANS; MICRODIALYSIS; MOBILE APPLICATIONS; MONITORING, PHYSIOLOGIC; OXIMETRY; PHOTOGRAPHY; PHOTOPLETHYSMOGRAPHY; POSTOPERATIVE CARE; SPECTROSCOPY, NEAR-INFRARED; ULTRASONOGRAPHY, DOPPLER;

EID: 84942818125     PISSN: 01487043     EISSN: 15363708     Source Type: Journal    
DOI: 10.1097/SAP.0b013e3181f8cb32     Document Type: Review

References (208)

1. Bui DT, Cordeiro PG, Hu QY, et al. Free flap reexploration: indications, treatment, and outcomes in 1193 free flaps. Plast Reconstr Surg. 2007; 119: 2092-2100.
2. Smit JM, AcostaR, Zeebregts CJ, et al. Early reintervention of compromised free flaps improves success rate. Microsurgery. 2007; 27: 612-616.
3. Gill PS, Hunt JP, Guerra AB, et al. A 10-year retrospective review of 758 DIEP flaps for breast reconstruction. Plast Reconstr Surg. 2004; 113: 1153-1160.
4. Nakatsuka T, Harii K, Asato H, et al. Analytic review of 2372 free flap transfers for head and neck reconstruction following cancer resection. J Reconstr Microsurg. 2003; 19: 363-368; discussion 369.
5. Mirzabeigi MN, Wang T, Kovach SJ, et al. Free flap take-back following postoperative microvascular compromise: predicting salvage versus failure. Plast Reconstr Surg. 2012; 130: 579-589.
6. RozenWM, Anavekar NS, AshtonMW, et al. Does the preoperative imaging of perforators with CT angiography improve operative outcomes in breast reconstruction? Microsurgery. 2008; 28: 516-523.
7. Rozen WM, Garcia-Tutor E, Alonso-Burgos A, et al. Planning and optimising DIEP flapswith virtual surgery: theNavarra experience. J Plast Reconstr Aesthet Surg. 2010; 63: 289-297.
8. Holm C, Mayr M, Hofter E, et al. Interindividual variability of the SIEA Angiosome: effects on operative strategies in breast reconstruction. Plast Reconstr Surg. 2008; 122: 1612-1620.
9. Lohman RF, Ozturk CN, Ozturk C, et al. An analysis of current techniques used for intraoperative flap evaluation. (PAP DOI 10.1097). Ann Plast Surg. 2014.
10. Wax MK. The role of the implantable Doppler probe in free flap surgery. Laryngoscope. 2014; 124(Suppl 1): S1-12.
11. Al-Dam A, Zrnc TA, Hanken H, et al. Outcome of microvascular free flaps in a high-volume training centre. J Craniomaxillofac Surg. 2014.
12. Liu Y, Zhao YF, Huang JT, et al. Analysis of 13 cases of venous compromise in 178 radial forearm free flaps for intraoral reconstruction. Int J Oral Maxillofac Surg. 2012; 41: 448-452.
13. Gao R, Loo S. Review of 100 consecutive microvascular free flaps. N Z Med J. 2011; 124: 49-56.
14. Disa JJ, Cordeiro PG, Hidalgo DA. Efficacy of conventional monitoring techniques in free tissue transfer: an 11-year experience in 750 consecutive cases. Plast Reconstr Surg. 1999; 104: 97-101.
15. Yang Q, Ren ZH, Chickooree D, et al. The effect of early detection of anterolateral thigh free flap crisis on the salvage success rate, based on 10 years of experience and 1072 flaps. Int J Oral Maxillofac Surg. 2014; 43: 1059-1063.
16. Chang EI, Carlsen BT, Festekjian JH, et al. Salvage rates of compromised free flap breast reconstruction after recurrent thrombosis. Ann Plast Surg. 2013; 71: 68-71.
17. Siemionow M, Arslan E. Ischemia/reperfusion injury: a review in relation to free tissue transfers. Microsurgery. 2004; 24: 468-475.
18. Koshima I, Fukuda H, Yamamoto H, et al. Free anterolateral thigh flaps for reconstruction of head and neck defects. Plast Reconstr Surg. 1993; 92: 421-428; discussion 429-430.
19. Jallali N, Ridha H, Butler PE. Postoperative monitoring of free flaps in UK plastic surgery units. Microsurgery. 2005; 25: 469-472.
20. Whitaker IS, Oliver DW, Ganchi PA. Postoperative monitoring of microvascular tissue transfers: current practice in the United kingdom and Ireland. Plast Reconstr Surg. 2003; 111: 2118-2119.
21. Whitaker IS, Gulati V, Ross GL, et al. Variations in the postoperative management of free tissue transfers to the head and neck in the United Kingdom. Br J Oral Maxillofac Surg. 2007; 45: 16-18.
22. Smit JM, Zeebregts CJ, Acosta R. Timing of presentation of the first signs of vascular compromise dictates the salvage outcome of free flap transfers. Plast Reconstr Surg. 2008; 122: 991-992.
23. Hofer SO, Damen TH,MureauMA, et al. A critical reviewof perioperative complications in 175 free deep inferior epigastric perforator flap breast reconstructions. Ann Plast Surg. 2007; 59: 137-142.
24. Chen KT, Mardini S, Chuang DC, et al. Timing of presentation of the first signs of vascular compromise dictates the salvage outcome of free flap transfers. Plast Reconstr Surg. 2007; 120: 187-195.
25. May JW Jr, Chait LA, O'Brien BM, et al. The no-reflow phenomenon in experimental free flaps. Plast Reconstr Surg. 1978; 61: 256-267.
26. Creech B,Miller S. Evaluation of circulation in skin flaps. In: GrabbWC,Myers MB, eds. Skin flaps. Boston, MA: Little, Brown; 1975.
27. Lineaweaver WC. The implantable Doppler probe. Plast Reconstr Surg. 1988; 82: 1099-1100.
28. Whitney TM, Lineaweaver WC, Billys JB, et al. Improved salvage of complicated microvascular transplants monitored with quantitative fluorometry. Plast Reconstr Surg. 1992; 90: 105-111.
29. Kind GM, Buntic RF, Buncke GM, et al. The effect of an implantable Doppler probe on the salvage of microvascular tissue transplants. Plast Reconstr Surg. 1998; 101: 1268-1273; discussion 1274-1265.
30. RozenWM, Chubb D, Whitaker IS, et al. The efficacy of postoperative monitoring: a single surgeon comparison of clinical monitoring and the implantable Doppler probe in 547 consecutive free flaps. Microsurgery. 2010; 30: 105-110.
31. Smit JM, Werker PM, Liss AG, et al. Introduction of the implantable Doppler system did not lead to an increased salvage rate of compromised flaps: a multivariate analysis. Plast Reconstr Surg. 2010; 125: 1710-1717.
32. Schmulder A, Gur E, Zaretski A. Eight-year experience of the Cook-Swartz Doppler in free-flap operations: microsurgical and reexploration results with regard to a wide spectrum of surgeries. Microsurgery. 2011; 31: 1-6.
33. Lin SJ, NguyenMD, Chen C, et al. Tissue oximetry monitoring in microsurgical breast reconstruction decreases flap loss and improves rate of flap salvage. Plast Reconstr Surg. 2011; 127: 1080-1085.
34. SteeleMH. Three-year experience using near infrared spectroscopy tissue oximetry monitoring of free tissue transfers. Ann Plast Surg. 2011; 66: 540-545.
35. Goldberg J, Sepka RS, Perona BP, et al. Laser Doppler blood flow measurements of common cutaneous donor sites for reconstructive surgery. Plast Reconstr Surg. 1990; 85: 581-586.
36. Hwang JH, Mun GH. An evolution of communication in postoperative free flap monitoring: using a smartphone and mobile messenger application. Plast Reconstr Surg. 2012; 130: 125-129.
37. Lohman RF, Langevin CJ, Bozkurt M, et al. A prospective analysis of free flap monitoring techniques: physical examination, external Doppler, implantable Doppler, and tissue oximetry. J Reconstr Microsurg. 2013; 29: 51-56.
38. Whitaker IS, Pratt GF, RozenWM, et al. Near infrared spectroscopy for monitoring flap viability following breast reconstruction. J Reconstr Microsurg. 2012; 28: 149-154.
39. Cornejo A, Rodriguez T, Steigelman M, et al. The use of visible light spectroscopy to measure tissue oxygenation in free flap reconstruction. J Reconstr Microsurg. 2011; 27: 397-402.
40. Fox PM, Zeidler K, Carey J, et al. Microsurgery. 2013; 33: 198-202.
41. Rimler J, Ponticorvo A, Taydas E, et al. A Critical Evaluation of Human Perception in Conventional Flap Monitoring Versus Spatial Frequency Domain Imaging. Plast Reconstr Surg. 2014; 134(4S-1 Suppl): 73.
42. Chen HC, Kuo HC, Chung KP, et al. Quality improvement of microsurgery through telecommunication-the postoperative care after microvascular transfer of intestine. Microsurgery. 2012; 32: 96-102.
43. Henault B, Pluvy I, Pauchot J, et al. Capillary measurement of lactate and glucose for free flap monitoring. Ann Chir Plast Esthet. 2014; 59: 15-21.
44. Heller L, Levin LS, Klitzman B. Laser Doppler flowmeter monitoring of freetissue transfers: blood flow in normal and complicated cases. Plast Reconstr Surg. 2001; 107: 1739-1745.
45. de la Torre J, Hedden W, Grant JH 3rd, et al. Retrospective review of the internal Doppler probe for intra- and postoperative microvascular surveillance. J Reconstr Microsurg. 2003; 19: 287-290.
46. UmGT, Chang J, Louie O, et al. Implantable Cook-Swartz Doppler probe versus Synovis FlowCoupler for the post-operative monitoring of free flap breast reconstruction. J Plast Reconstr Aesthet Surg. 2014; 67: 960-966.
47. Zhang T, Lubek J, Salama A, et al. Venous anastomoses using microvascular coupler in free flap head and neck reconstruction. J Oral Maxillofac Surg. 2012; 70: 992-996.
48. Oxford Centre for Evidence-Based Medicine. Levels of Evidence. 2009. Available at: www.cebm.net. Accessed October 1, 2014.
49. YiiNW, Evans GR,MillerMJ, et al. Thrombolytic therapy: what is its role in free flap salvage? Ann Plast Surg. 2001; 46: 601-604.
50. PanchapakesanV, Addison P, Beausang E, et al. Role of thrombolysis in free-flap salvage. J ReconstrMicrosurg. 2003; 19: 523-530.
51. Kroll SS, Schusterman MA, Reece GP, et al. Timing of pedicle thrombosis and flap loss after free-tissue transfer. Plast Reconstr Surg. 1996; 98: 1230-1233.
52. Khouri RK, Cooley BC, Kunselman AR, et al. A prospective study of microvascular free-flap surgery and outcome. Plast Reconstr Surg. 1998; 102: 711-721.
53. Brown JS, Devine JC, Magennis P, et al. Factors that influence the outcome of salvage in free tissue transfer. Br J Oral Maxillofac Surg. 2003; 41: 16-20.
54. Chubb D, Rozen WM, Whitaker IS, et al. The efficacy of clinical assessment in the postoperative monitoring of free flaps: a review of 1140 consecutive cases. Plast Reconstr Surg. 2010; 125: 1157-1166.
55. Ensat F, Schubert H, Hladik M, et al. [Soft tissue reconstruction in the extremities and the head and neck area using the anterolateral thigh free flap]. Oper Orthop Traumatol. 2013; 25: 176-184.
56. Tan NC, Shih HS, Chen CC, et al. Distal skin paddle as a monitor for buried anterolateral thigh flap in pharyngoesophageal reconstruction. Oral Oncol. 2012; 48: 249-252.
57. Revenaugh PC, Waters HH, Scharpf J, et al. Suprastomal cutaneous monitoring paddle for free flap reconstruction of laryngopharyngectomy defects. JAMA Facial Plast Surg. 2013; 15: 287-291.
58. Dodakundi C, DoiK,HattoriY, et al.Viability of the skin paddle does not predict the functional outcome in free muscle transfers with a second ischemic event: a report of three cases. J ReconstrMicrosurg. 2012; 28: 267-271.
59. Laporta R, Longo B, Sorotos M, et al. Diep flap sentinel skin paddle positioning algorithm. In: Microsurgery. 2014.
60. Hallock GG. Simultaneous transposition of anterior thigh muscle and fascia flaps: an introduction to the chimera flap principle. Ann Plast Surg. 1991; 27: 126-131.
61. Huang WC, Chen HC, Jain V, et al. Reconstruction of through-and-through cheek defects involving the oral commissure, using chimeric flaps fromthe thigh lateral femoral circumflex system. Plast Reconstr Surg. 2002; 109: 433-441; discussion 442-433.
62. Lin CT, Chen SG, Chen TM, et al. Is monitor flap monitoring? Microsurgery. 2014; 34: 164-166.
63. Dionyssopoulos A, Odobescu A, Foroughi Y, et al. Monitoring buried jejunum free flaps with a sentinel: a retrospective study of 20 cases. Laryngoscope. 2012; 122: 519-522.
64. Kashimura T, Nakazawa H, Shimoda K, et al. False-negative monitoring flap in free jejunal transfer. J Reconstr Microsurg. 2013; 29: 137-140.
65. Miyamoto S,Kayano S,Umezawa H, et al. Vastus lateralis muscle flaps for monitoring buried anterolateral thigh flaps. J Craniofac Surg. 2013; 24: 1739-1740.
66. Kim SC, Kim EK. Externalized monitoring of totally buried free flap in hypopharyngeal reconstruction. J Craniofac Surg. 2013; 24: 575-578.
67. Parker PM, Fischer JC, Shaw WW. Implantable pulsed Doppler cuff for longterm monitoring of free flaps: a preliminary study. Microsurgery. 1984; 5: 130-135.
68. SwartzWM, Jones NF, Cherup L, et al. Directmonitoring ofmicrovascular anastomoseswith the 20-MHz ultrasonic Doppler probe: an experimental and clinical study. Plast Reconstr Surg. 1988; 81: 149-161.
69. Whitaker IS, Smit JM, Acosta R. A simple method of implantable Doppler cuff attachment: experience in 150 DIEP breast reconstructions. J Plast Reconstr Aesthet Surg. 2008; 61: 1251-1252.
70. Oliver DW, Whitaker IS, Giele H, et al. The Cook-Swartz venous Doppler probe for the post-operative monitoring of free tissue transfers in the United Kingdom: a preliminary report. Br J Plast Surg. 2005; 58: 366-370.
71. Bill TJ, Foresman PA, Rodeheaver GT, et al. Fibrin sealant: a novel method of fixation for an implantable ultrasonicmicroDoppler probe. J ReconstrMicrosurg. 2001; 17: 257-262.
72. Rozen WM, Ang GG, McDonald AH, et al. Sutured attachment of the implantable Doppler probe cuff for large or complex pedicles in free tissue transfer. J ReconstrMicrosurg. 2011; 27: 99-102.
73. SwartzWM, Izquierdo R,MillerMJ. Implantable venous Doppler microvascular monitoring: laboratory investigation and clinical results. Plast Reconstr Surg. 1994; 93: 152-163.
74. FrostMW, Niumsawatt V, RozenWM, et al. Direct comparison of postoperative monitoring of free flaps with microdialysis, implantable cook-Swartz Doppler probe, and clinical monitoring in 20 consecutive patients. Microsurgery. 2014.
75. Zhang T, Dyalram-Silverberg D, Bui T, et al. Analysis of an implantable venous anastomotic flow coupler: experience in head and neck free flap reconstruction. Int J Oral Maxillofac Surg. 2012; 41: 751-755.
76. Paydar KZ, Hansen SL, Chang DS, et al. Implantable venous Doppler monitoring in head and neck free flap reconstruction increases the salvage rate. Plast Reconstr Surg. 2010; 125: 1129-1134.
77. Ho MW, Cassidy C, Brown JS, et al. Rationale for the use of the implantable Doppler probe based on 7 years' experience. Br J Oral Maxillofac Surg. 2014; 52: 530-534.
78. Poder TG, Fortier PH. Implantable Doppler in monitoring free flaps: a costeffectiveness analysis based on a systematic review of the literature. Eur Ann Otorhinolaryngol Head Neck Dis. 2013; 130: 79-85.
79. Smit JM, Whitaker IS, LissAG, et al. Post operative monitoring of microvascular breast reconstructions using the implantable Cook-Swartz Doppler system: a study of 145 probes & technical discussion. J Plast Reconstr Aesthet Surg. 2009; 62: 1286-1292.
80. Smit JM, Klein S, de Jong EH, et al. Value of the implantable doppler system in free flap monitoring. J Plast Reconstr Aesthet Surg. 2012; 65: 1276-1277.
81. Rosenberg JJ, Fornage BD, Chevray PM. Monitoring buried free flaps: limitations of the implantable Doppler and use of color duplex sonography as a confirmatory test. Plast Reconstr Surg. 2006; 118: 109-113; discussion 114-105.
82. Iblher N, Eisenhardt SU, Penna V, et al. A newevaluation tool for monitoring devices and its application to evaluate the implantable Doppler probe. J Reconstr Microsurg. 2010; 26: 265-270.
83. Kim JT, Ho SY, KimYH. A chimaeric-pattern flap design for implantable Doppler surrogate monitoring: a novel placement technique. J Plast Reconstr Aesthet Surg. 2014; 67: 190-197.
84. Udesen A, Lontoft E, Kristensen SR. Monitoring of free TRAM flaps with microdialysis. J ReconstrMicrosurg. 2000; 16: 101-106.
85. Edsander-Nord A, Rojdmark J, Wickman M. Metabolism in pedicled and free TRAM flaps: a comparison using the microdialysis technique. Plast Reconstr Surg. 2002; 109: 664-673.
86. Whitaker IS, Rozen WM, Chubb D, et al. Postoperative monitoring of free flaps in autologous breast reconstruction: a multicenter comparison of 398 flaps using clinical monitoring, microdialysis, and the implantable Doppler probe. J Reconstr Microsurg. 2010; 26: 409-416.
87. Brueggemann A, Noltze A, Lange T, et al. Significant [C3a] increase in free flaps after prolonged ischemia. J Surg Res. 2008; 150: 125-130.
88. Ionac M, Schaefer D, Geishauser M. Thromboxane A2 release in ischemia and reperfusion of free flaps in rats, studied by microdialysis. J Reconstr Microsurg. 2001; 17: 139-143.
89. Kristensen DL, Ladefoged SA, Sloth E, et al. Microdialysis: characterisation of haematomas in myocutaneous flaps by use of biochemical agents. Br J Oral Maxillofac Surg. 2013; 51: 117-122.
90. Setala L, Gudaviciene D. Glucose and lactate metabolism in well-perfused and compromised microvascular flaps. J ReconstrMicrosurg. 2013; 29: 505-510.
91. Allen WN, King A, Blackburn TK. Microdialysis monitoring of a craniofacial microvascular free flap reconstruction detected critical brain swelling. Br J Neurosurg. 2013; 27: 701-703.
92. Nielsen HT, Gutberg N, Birke-Sorensen H. Monitoring of intraoral free flaps with microdialysis. Br J Oral Maxillofac Surg. 2011; 49: 521-526.
93. Birke-Sorensen H, Toft G, Bengaard J. Pure muscle transfers can be monitored by use of microdialysis. J Reconstr Microsurg. 2010; 26: 623-630.
94. SvaerdborgM, Birke-Sorensen H.Monitored extended secondary arterial ischemia in a free muscle transfer. J ReconstrMicrosurg. 2012; 28: 119-124.
95. Sorensen HB. Free jejunal flaps can be monitored by use of microdialysis. J Reconstr Microsurg. 2008; 24: 443-448.
96. Mourouzis C, Anand R, Bowden JR, et al. Microdialysis: use in the assessment of a buried bone-only fibular free flap. Plast Reconstr Surg. 2007; 120: 1363-1366.
97. Jyranki J, Suominen S, Vuola J, et al. Microdialysis in clinical practice: monitoring intraoral free flaps. Ann Plast Surg. 2006; 56: 387-393.
98. Setala L, Papp A, Romppanen EL, et al. Microdialysis detects postoperative perfusion failure in microvascular flaps. J ReconstrMicrosurg. 2006; 22: 87-96.
99. Prasetyono TO, Adianto S. The relationship between oxygen saturation and color alteration of a compromised skin flap: experimental study on the rabbit. Arch Plast Surg. 2013; 40: 505-509.
100. Achauer BM, Black KS, Beran AV, et al. Transcutaneous PO2 monitoring of flap circulation following surgery. Birth Defects Orig Artic Ser. 1979; 15: 517-522.
101. Achauer BM, Black KS, Litke DK. Transcutaneous PO2 in flaps: a new method of survival prediction. Plast Reconstr Surg. 1980; 65: 738-745.
102. Serafin D, Lesesne CB, Mullen RY, et al. Transcutaneous PO2 monitoring for assessing viability and predicting survival of skin flaps: experimental and clinical correlations. J Microsurg. 1981; 2: 165-178.
103. Mahoney JL, Lista FR. Variations in flap blood flow and tissue PO2: a new technique for monitoring flap viability. Ann Plast Surg. 1988; 20: 43-47.
104. Irwin MS, Thorniley MS, Dore CJ, et al. Near infra-red spectroscopy: a noninvasive monitor of perfusion and oxygenation within the microcirculation of limbs and flaps. Br J Plast Surg. 1995; 48: 14-22.
105. Hirigoyen MB, Blackwell KE, Zhang WX, et al. Continuous tissue oxygen tension measurement as a monitor of free-flap viability. Plast Reconstr Surg. 1997; 99: 763-773.
106. Lindsey LA,Watson JD, Quaba AA. Pulse oximetry in postoperative monitoring of free muscle flaps. Br J Plast Surg. 1991; 44: 27-29.
107. ScheuflerO, Exner K, Andresen R. Investigation of TRAMflap oxygenation and perfusion by near-infrared reflection spectroscopy and color-coded duplex sonography. Plast Reconstr Surg. 2004; 113: 141-152; discussion 153-145.
108. Holzle F, LoeffelbeinDJ, NolteD, et al. Free flap monitoring using simultaneous noninvasive laser Doppler flowmetry and tissue spectrophotometry. J Craniomaxillofac Surg. 2006; 34: 25-33.
109. Ozturk CN, Ozturk C, Ledinh W, et al. Variables affecting postoperative tissue perfusion monitoring in free flap breast reconstruction. In: Microsurgery. 2014.
110. Repez A, Oroszy D, Arnez ZM. Continuous postoperative monitoring of cutaneous free flaps using near infrared spectroscopy. J Plast Reconstr Aesthet Surg. 2008; 61: 71-77.
111. Colwell AS, Wright L, Karanas Y. Near-infrared spectroscopy measures tissue oxygenation in free flaps for breast reconstruction. Plast Reconstr Surg. 2008; 121: 344e-345e.
112. Keller A. Noninvasive tissue oximetry for flap monitoring: an initial study. J ReconstrMicrosurg. 2007; 23: 189-197.
113. Pelletier A, Tseng C, Agarwal S, et al. Cost analysis of near-infrared spectroscopy tissue oximetry for monitoring autologous free tissue breast reconstruction. J ReconstrMicrosurg. 2011; 27: 487-494.
114. Gioux S, Mazhar A, Lee BT, et al. First-in-human pilot study of a spatial frequency domain oxygenation imaging system. J Biomed Opt. 2011; 16: 086015.
115. Pharaon MR, Scholz T, Bogdanoff S, et al. Early detection of complete vascular occlusion in a pedicle flapmodel using quantitative [corrected] spectral imaging. Plast Reconstr Surg. 2010; 126: 1924-1935.
116. Meier JK, Prantl L, Muller S, et al. Simple, fast and reliable perfusion monitoring of microvascular flaps. Clin Hemorheol Microcirc. 2012; 50: 13-24.
117. Mueller S, Meier JK, Wendl CM, et al. Mandibular reconstruction with microvascular re-anastomosed fibular free flaps-two complementary methods of postoperative transplant monitoring. Clin Hemorheol Microcirc. 2012; 52: 141-151.
118. Hashimoto I, Nakanishi H, Takiwaki H, et al. Flapmonitoring by transcutaneous PO2 and PCO2: importance of transcutaneous PCO2 in determining follow-up treatment for compromised free flaps. J Reconstr Microsurg. 2007; 23: 269-274.
119. Jonas R, Schael T, Krimmel M, et al.Monitorin in microvascular tissue transfer by measurement of oxygen partial pressure: four years experience with 125 microsurgical transplants. J Craniomaxillofac Surg. 2013; 41: 303-309.
120. Hallock GG. Physiological studies using laser Doppler flowmetry to compare blood flow to the zones of the free TRAM flap. Ann Plast Surg. 2001; 47: 229-233.
121. Salmi AM, Tukiainen E, Asko-Seljavaara S. Thermographic mapping of perforators and skin blood flow in the free transverse rectus abdominis musculocutaneous flap. Ann Plast Surg. 1995; 35: 159-164.
122. Figus A,Mosahebi A, Ramakrishnan V. Microcirculation in DIEP flaps: a study of the haemodynamics using laser Doppler flowmetry and lightguide reflectance spectrophotometry. J Plast Reconstr Aesthet Surg. 2006; 59: 604-612; discussion 613.
123. Yanaga H, TaiY, Kiyokawa K, et al. An ipsilateral superdrainaged transverse rectus abdominis myocutaneous flap for breast reconstruction. Plast Reconstr Surg. 1999; 103: 465-472.
124. Ribuffo D, Muratori L, Antoniadou K, et al. A hemodynamic approach to clinical results in the TRAMflap after selective delay. Plast Reconstr Surg. 1997; 99: 1706-1714.
125. Tuominen HP, Asko-Seljavaara S, Svartling NE. Cutaneous blood flow in the free TRAM flap. Br J Plast Surg. 1993; 46: 665-669.
126. Tuominen HP, Asko-Seljavaara S, Svartling NE, et al. Cutaneous blood flow in the TRAM flap. Br J Plast Surg. 1992; 45: 261-269.
127. Jones BM, Mayou BJ. The Laser Doppler flowmeter for microvascularmonitoring: a preliminary report. Br J Plast Surg. 1982; 35: 147-149.
128. Svensson H, Pettersson H, Svedman P. Laser Doppler flowmetry and laser photometry for monitoring free flaps. Scand J Plast Reconstr Surg. 1985; 19: 245-249.
129. Yvonne-Tee GB, Rasool AH, Halim AS, et al. Noninvasive assessment of cutaneous vascular function in vivo using capillaroscopy, plethysmography and laser- Doppler instruments: its strengths and weaknesses. Clin Hemorheol Microcirc. 2006; 34: 457-473.
130. Yuen JC, Feng Z.Monitoring free flaps using the laser Doppler flowmeter: fiveyear experience. Plast Reconstr Surg. 2000; 105: 55-61.
131. Mucke T, Wolff KD, Rau A, et al. Autonomization of free flaps in the oral cavity: A prospective clinical study. Microsurgery. 2012; 32: 201-206.
132. Rothenberger J, Amr A, Schaller HE, et al. Evaluation of a non-invasive monitoring method for free flap breast reconstruction using laser Doppler flowmetry and tissue spectrophotometry. Microsurgery. 2013; 33: 350-357.
133. Mucke T, Rau A, Merezas A, et al. Identification of perioperative risk factor by laser-Doppler spectroscopy after free flap perfusion in the head and neck: a prospective clinical study. Microsurgery. 2014; 34: 345-351.
134. McCraw JB, Myers B, Shanklin KD. The value of fluorescein in predicting the viability of arterialized flaps. Plast Reconstr Surg. 1977; 60: 710-719.
135. SilvermanDG, Cedrone FA, Hurford WE, et al. Monitoring tissue elimination of fluorescein with the perfusion fluorometer: a new method to assess capillary blood flow. Surgery. 1981; 90: 409-417.
136. Denneny JC 3rd, Weisman RA, Silverman DG. Monitoring free flap perfusion by serial fluorometry. Otolaryngol Head Neck Surg. 1983; 91: 372-376.
137. Silverman DG, Kim DJ, Brousseau DA, et al. Fluorescence assessment of skin perfusion after oral fluorescein. Surgery. 1988; 103: 221-225.
138. Issing WJ, Naumann C. Evaluation of pedicled skin flap viability by pH, temperature and fluorescein: an experimental study. J Craniomaxillofac Surg. 1996; 24: 305-309.
139. Rubben A, Eren S, Krein R, et al. Infrared videoangiofluorography of the skin with indocyanine green-rat random cutaneous flap model and results in man. Microvasc Res. 1994; 47: 240-251.
140. Eren S, Rubben A, Krein R, et al. Assessment of microcirculation of an axial skin flap using indocyanine green fluorescence angiography. Plast Reconstr Surg. 1995; 96: 1636-1649.
141. Eren S, Krein R, Hafemann B. Objective evaluation of the microcirculation in the skin with indocyanine green angiography (ICGA). A method for the clinic? Handchir Mikrochir Plast Chir. 1995; 27: 307-314.
142. Nagata T, Masumoto K, Uchiyama Y, et al. Improved technique for evaluating oral free flaps by pinprick testing assisted by indocyanine green near-infrared fluorescence angiography. J Craniomaxillofac Surg. 2014.
143. Mothes H, Donicke T, Friedel R, et al. Indocyanine-green fluorescence video angiography used clinically to evaluate tissue perfusion in microsurgery. J Trauma. 2004; 57: 1018-1024.
144. Su Z, Ye P, Teng Y, et al. Adverse reaction in patients with drug allergy history after simultaneous intravenous fundus fluorescein angiography and indocyanine green angiography. J Ocul Pharmacol Ther. 2012; 28: 410-413.
145. Polom K,Murawa D, Rho YS, et al. Current trends and emerging future of indocyanine green usage in surgery and oncology: a literature review. Cancer. 2011; 117: 4812-4822.
146. Newman MI, SamsonMC, Tamburrino JF, et al. Intraoperative laser-assisted indocyanine green angiography for the evaluation of mastectomy flaps in immediate breast reconstruction. J Reconstr Microsurg. 2010; 26: 487-492.
147. Harrison DH, Girling M, Mott G. Experience in monitoring the circulation in free-flap transfers. Plast Reconstr Surg. 1981; 68: 543-555.
148. May JW Jr, Lukash FN, Gallico GG 3rd, et al. Removable thermocouple probe microvascular patency monitor: an experimental and clinical study. Plast Reconstr Surg. 1983; 72: 366-379.
149. Khouri RK, Shaw WW. Monitoring of free flaps with surface-temperature recordings: is it reliable? Plast Reconstr Surg. 1992; 89: 495-499; discussion 500-492.
150. Chiu ES, Altman A, Allen RJ Jr, et al. Free flap monitoring using skin temperature strip indicators: adjunct to clinical examination. Plast Reconstr Surg. 2008; 122: 144e-145e.
151. Kannan RY. Early detection of inflow problems during free flap monitoring using digital tympanic thermometers. J Plast Reconstr Aesthet Surg. 2012; 65: e135.
152. Mofikoya BO, Ugburo AO. Early experiences with microvascular free tissue transfer in Lagos, Nigeria. Niger J Surg. 2014; 20: 35-37.
153. Yamamoto T, Todokoro T, Koshima I. Handheld thermography for flap monitoring. J Plast Reconstr Aesthet Surg. 2012; 65: 1747-1748.
154. Papillion P,Wong L,Waldrop J, et al. Infrared surface temperature monitoring in the postoperative management of free tissue transfers. Can J Plast Surg. 2009; 17: 97-101.
155. Kraemer R, Lorenzen J, KnoblochK, et al. Free flap microcirculatory monitoring correlates to free flap temperature assessment. J Plast Reconstr Aesthet Surg. 2011; 64: 1353-1358.
156. Hara H, Mihara M, Iida T, et al. Blood glucose measurement in flap monitoring for salvage of flaps from venous thrombosis. Plast Reconstr Surg. 2012; 129: 587e-589e.
157. Hara H, Mihara M, Iida T, et al. Blood glucose measurement for flap monitoring to salvage flaps from venous thrombosis. J Plast Reconstr Aesthet Surg. 2012; 65: 616-619.
158. Di Lorenzo S, Corradino B. Detection of flap venous and arterial occlusion using interstitial glucose monitoring in a rodent model. Plast Reconstr Surg. 2011; 127: 1396author reply 1396-1397.
159. Hara H, Mihara M, NarushimaM, et al. Flap salvage following postoperative venous thrombosis diagnosed by blood glucose measurement in the flaps. Eplasty. 2011; 11: e28.
160. Sakakibara S,HashikawaK,Omori M, et al.Asimplest method of flap monitoring. J ReconstrMicrosurg. 2010; 26: 433-434.
161. Setala LP, Korvenoja EM, Harma MA, et al. Glucose, lactate, and pyruvate response in an experimental model ofmicrovascular flap ischemia and reperfusion: a microdialysis study. Microsurgery. 2004; 24: 223-231.
162. Tachakra S, Wang XH, Istepanian RS, Song YH. Mobile e-health: the unwired evolution of telemedicine. Telemed J E Health. 2003; 9: 247-257.
163. Baldwin AJ, Langton SG. Postoperative monitoring of flaps by digital camera and Internet link. Br J Oral Maxillofac Surg. 2001; 39: 120-121.
164. Engel H, Huang JJ, Tsao CK, et al. Remote real-time monitoring of free flaps via smartphone photography and 3G wireless Internet: a prospective study evidencing diagnostic accuracy. Microsurgery. 2011; 31: 589-595.
165. Kiranantawat K, Sitpahul N, Taeprasartsit P, et al. The first Smartphone application for microsurgery monitoring: SilpaRamanitor. Plast Reconstr Surg. 2014; 134: 130-139.
166. Gardiner S, Hartzell TL. Telemedicine and plastic surgery: a review of its applications, limitations and legal pitfalls. J Plast Reconstr Aesthet Surg. 2012; 65: e47-53.
167. Kyriacou PA. Direct pulse oximetry within the esophagus, on the surface of abdominal viscera, and on free flaps. Anesth Analg. 2013; 117: 824-833.
168. Zaman T, Kyriacou PA, Pal SK. Free flap pulse oximetry utilizing reflectance photoplethysmography. Conf Proc IEEE Eng Med Biol Soc. 2013; 2013: 4046-4049.
169. Hales JR, Stephens FR, Fawcett AA, et al. Observations on a new non-invasive monitor of skin blood flow. Clin Exp Pharmacol Physiol. 1989; 16: 403-415.
170. Stack BC Jr, Futran ND, Shohet MJ, et al. Spectral analysis of photoplethysmograms from radial forearm free flaps. Laryngoscope. 1998; 108: 1329-1333.
171. Stack BC Jr, Futran ND, Zang B, et al. Initial experience with personal digital assistant-based reflectance photoplethysmograph for free tissue transfer monitoring. Ann Plast Surg. 2003; 51: 136-140.
172. Chubb D, Rozen WM, Ashton MW. Early survival of a compromised fasciocutaneous flapwithout pedicle revision: monitoring with photoplethysmography. Microsurgery. 2010; 30: 462-465.
173. Salgado CJ, Moran SL, Mardini S. Flap monitoring and patient management. Plast Reconstr Surg. 2009; 124(6 Suppl): e295-302.
174. vanWingerden JJ, Collins JM, Coret EH, et al. Early monitoring of the viability of the buried intrathoracic omental flap: a feasibility study. Ann Thorac Surg. 2010; 90: 1332-1336.
175. Vakharia KT, Henstrom D, Lindsay R, et al. Color Doppler ultrasound: effective monitoring of the buried free flap in facial reanimation. Otolaryngol Head Neck Surg. 2012; 146: 372-376.
176. Arya R, Griffiths L, Figus A, et al. Post-operative assessment of perfusion of Deep Inferior Epigastric Perforator (DIEP) free flaps via Pulsatility Index (PI) using a portable colour Doppler sonogram device. J Plast Reconstr Aesthet Surg. 2013; 66: 931-936.
177. Prantl L, Schmitt S,Gais S, et al. Contrast harmonic ultrasound and indocyaninegreen fluorescence video angiography for evaluation of dermal and subdermal microcirculation in free parascapular flaps. Clin Hemorheol Microcirc. 2008; 38: 31-44.
178. Muller S, Gosau M, Strobel D, et al. Assessment of bone microcirculation by contrast-enhanced ultrasound (CEUS) and [18F]-positron emission tomography/computed tomography in free osseous and osseocutaneus flaps for mandibular reconstruction: preliminary results. Clin Hemorheol Microcirc. 2011; 49(1-4): 115-128.
179. Lamby P, Prantl L, Fellner C, et al. Post-operative monitoring of tissue transfers: advantages using contrast enhanced ultrasound (CEUS) and contrast enhanced MRI (ceMRI) with dynamic perfusion analysis? Clin Hemorheol Microcirc. 2011; 48: 105-117.
180. Fellner C, Prantl L, Rennert J, et al. Comparison of time-intensity-curve- (TIC-) analysis of contrast-enhanced ultrasound (CEUS) and dynamic contrast-enhanced (DCE) MRI for postoperative control of microcirculation in free flaps-first results and critical comments. Clin Hemorheol Microcirc. 2011; 48: 187-198.
181. Prantl L, Pfister K, Kubale R, et al. Value of high resolution ultrasound and contrast enhanced US pulse inversion imaging for the evaluation of the vascular integrity of free-flap grafts. Clin Hemorheol Microcirc. 2007; 36: 203-216.
182. Prantl L, Pfeifer C, Geis S, et al. Osteocutaneous free flaps: a critical analysis of quantitative evaluation of bone microcirculation with contrast-enhanced high resolution ultrasound (hrCEUS) and TIC analysis. Clin Hemorheol Microcirc. 2011; 49: 251-259.
183. Geis S, Prantl L, Gehmert S, et al. TTP (time to PEAK) and RBV (regional blood volume) as valuable parameters to detect early flap failure. Clin Hemorheol Microcirc. 2011; 48: 81-94.
184. Geis S, Prantl L, Mueller S, et al. Quantitative assessment of bone microvascularization after osteocutaneous flap transplantation using contrast-enhanced ultrasound (CEUS). Ultraschall Med. 2013; 34: 272-279.
185. Sharma S, Anand R, Hickman M, et al. Power modulation contrast enhanced ultrasound for postoperative perfusion monitoring following free tissue transfer in head and neck surgery. Int J Oral Maxillofac Surg. 2010; 39: 1211-1217.
186. Geis S, Prantl L, Dolderer J, et al. Postoperative monitoring of local and free flaps with contrast-enhanced ultrasound (CEUS)-analysis of 112 patients. Ultraschall Med. 2013; 34: 550-558.
187. Larsson L.An electrophysiological method for monitoring blood flow in skeletal muscle. An experimental study in the rat. Scand J Plast Reconstr Surg Hand Surg. 1989; 23: 181-186.
188. Harrison DH, Mott G. Impedance monitoring for subcutaneous free flap transfers. Br J Plast Surg. 1989; 42: 318-323.
189. Concannon MJ, Stewart DH, Welsh CF, et al. Impedance plethysmography: a new method for continuous muscle perfusion monitoring. Plast Reconstr Surg. 1991; 88: 292-298.
190. Goedhart PT, KhalilzadaM, Bezemer R, et al. Sidestream Dark Field (SDF) imaging: a novel stroboscopic LEDring-based imaging modality for clinical assessment of the microcirculation. Opt Express. 2007; 15: 15101-15114.
191. Milstein DM, Lindeboom JA, Ince C. Intravital sidestream dark-field (SDF) imaging is used in a rabbit model for continuous noninvasive monitoring and quantification of mucosal capillary regeneration during wound healing in the oral cavity: a pilot study. Arch Oral Biol. 2010; 55: 343-349.
192. Hardwicke JT, Bella H,Waters RA. Sidestream Dark Field imaging as an adjunct to free flap monitoring. J Plast Reconstr Aesthet Surg. 2014; 67: 875-877.
193. AltintasMA, AltintasAA, Guggenheim M, et al.Monitoring ofmicrocirculation in free transferred musculocutaneous latissimus dorsi flaps by confocal laser scanning microscopy-a promising non-invasive methodical approach. J Plast Reconstr Aesthet Surg. 2010; 63: 111-117.
194. Cerny V, Turek Z, Parizkova R. Orthogonal polarization spectral imaging. Physiol Res. 2007; 56: 141-147.
195. OlivierWA, Hazen A, Levine JP, et al. Reliable assessment of skin flap viability using orthogonal polarization imaging. Plast Reconstr Surg. 2003; 112: 547-555.
196. Langer S, Biberthaler P, Harris AG, et al. In vivo monitoring of microvessels in skin flaps: introduction of a novel technique. Microsurgery. 2001; 21: 317-324.
197. Erdmann D, Sweis R,Wong MS, et al. Current perspectives of orthogonal polarization spectral imaging in plastic surgery. Chirurg. 2002; 73: 827-832.
198. Tsuchida Y. Age-related changes in skin blood flow at four anatomic sites of the body in males studied by xenon-133. Plast Reconstr Surg. 1990; 85: 556-561.
199. Top H, Sarikaya A, Aygit AC, et al. Reviewof monitoring free muscle flap transfers in reconstructive surgery: role of 99mTc sestamibi scintigraphy. Nucl Med Commun. 2006; 27: 91-98.
200. Aygit AC, Sarikaya A. Technetium 99 m sestamibi scintigraphy for noninvasive assessment of muscle flap viability. Ann Plast Surg. 1999; 43: 338-340.
201. Schuepbach J, Dassonville O, Poissonnet G, et al. Early postoperative bone scintigraphy in the evaluation of microvascular bone grafts in head and neck reconstruction. Head Face Med. 2007; 3: 20.
202. Schrey AR, AitasaloKM, Kinnunen IA, et al. Functional evaluation of microvascular free flaps with positron emission tomography. J Plast Reconstr Aesthet Surg. 2006; 59: 158-165.
203. Schrey AR, Kinnunen IA, Grenman RA, et al. Monitoring microvascular free flaps with tissue oxygen measurement and PET. Eur Arch Otorhinolaryngol. 2008; 265(Suppl 1): S105-113.
204. Lee I, Kang SY, Heo CY, et al. Evaluation of flap tissue viability by F-18 FDG PET/CT. Nucl Med Mol Imaging. 2014; 48: 241-243.
205. Raskin DJ, Erk Y, Spira M, et al. Tissue pH monitoring in microsurgery: a preliminary evaluation of continuous tissue pH monitoring as an indicator of perfusion disturbances in microvascular free flaps. Ann Plast Surg. 1983; 11: 331-339.
206. DicksonMG, Sharpe DT. Continuous subcutaneous tissue pH measurement as a monitor of blood flow in skin flaps: an experimental study. Br J Plast Surg. 1985; 38: 39-42.
207. DunnRM, Kaplan IB, Mancoll J, et al. Experimental and clinical use of pH monitoring of free tissue transfers. Ann Plast Surg. 1993; 31: 539-545.
208. Machens HG, Mailaender P, Reimer R, et al. Postoperative blood flow monitoring after free-tissue transfer by means of the hydrogen clearance technique. Plast Reconstr Surg. 1997; 99: 493-505.