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Updated: Sep 20, 2025
Non-invasive Assessment of Microvascular and Endothelial Function
Published on: January 29, 2013
Real-Time Assessment of Free Flap Capillary Circulation Using Videocapillaroscopy.
Chihiro Matsui1, William W Lao1, Takakuni Tanaka1
1From the Department of Plastic and Reconstructive Surgery, Juntendo University School of Medicine; Center for Aesthetic Plastic Surgery; Department of Oral Surgery, Toyooka Public Hospital; Department of Plastic and Aesthetic Surgery, LULA Beauty Clinic; Department of Urology, Showa University Fujigaoka Hospital; Jikei University School of Medicine; and Lilla Craniofacial Clinic.
A novel videocapillaroscope offers objective, real-time monitoring of free flap microcirculation. This tool visualizes red blood cell movement, aiding surgical assessment and improving flap viability.
Area of Science:
- Microsurgery
- Vascular Surgery
- Medical Imaging
Background:
- Free tissue transfer is a common reconstructive surgical technique.
- Current methods for assessing flap microcirculation lack objective, real-time visualization.
- There is a need for advanced tools to monitor flap viability during surgery.
Purpose of the Study:
- To evaluate circulation changes in free flap skin using a novel videocapillaroscope.
- To assess the real-time microcirculatory response to pedicle vessel clamping.
- To determine the utility of videocapillaroscopy for objective flap monitoring.
Main Methods:
- Ten patients undergoing free flap transfer for head and neck cancer were studied.
- Videocapillaroscopy was used to observe flap skin capillary circulation post-elevation.
- Pedicle artery and vein clamping were performed to record circulatory changes.
Main Results:
- Clamping pedicle vessels halted red blood cell movement, which rapidly restored upon release.
- Artery clamping decreased visible vessels and caused flap whitening; vein clamping increased vessels and reddening.
- Videocapillaroscopy provided direct visualization of microcirculatory dynamics.
Conclusions:
- Novel videocapillaroscopy enables objective, real-time monitoring of free flap microcirculation.
- Direct visualization of capillary blood flow enhances surgical assessment of flap viability.
- This technology offers a significant advancement in reconstructive surgery monitoring.
