Postoperative Flap Care and Monitoring After Surgical Reconstruction
The success of microsurgical free flap reconstruction does not end at the final stitch but rather the judicious monitoring and postoperative flap care that take place after. Early detection of compromise to flap circulation can lead to a high salvage rate, and in order to do so, clinical judgment is paramount. However, adjuncts to aid the clinician in monitoring flap perfusion have rapidly developed. Various imaging techniques have been developed with the use of infrared Doppler imaging, handheld or implantable Doppler, infrared thermal readings, and telemedicine in routine monitoring of flaps. This chapter aims to provide an overview as well as the routine practices that we use in our unit which sees a high volume of microsurgical reconstruction. Optimizing overall care of the patient can also improve microsurgical flap success rates with the use of various agents postoperatively that promote or improve systemic and local perfusion of the flap. A dedicated team postoperatively with the skills and knowledge in flap monitoring and care ensures a high rate of microsurgical flap success as shown in this chapter.
- 2.Swartz JE, Aarts MC, Swart KM, Disa JJ, Gerressen M, Kuo YR, Wax MK, Grolman W, Braunius WW. The value of postoperative anticoagulants to improve flap survival in the free radial forearm flap: a systematic review and retrospective multicentre analysis. Clin Otolaryngol. 2015;40(6):600–9.CrossRefGoogle Scholar