Free flap monitoring: a review of current practice

Individual techniques for the postoperative monitoring of free flaps vary considerably. In order to establish the currently preferred protocols, a survey was conducted among micro-surgeons in North America using a mailed questionnaire. Data were received from 95 centers for the monitoring of 2,825 free flaps performed during 1994. Results indicate that rates for flap salvage and overall success with free tissue transfer are closely related to surgical experience (number of cases performed per month). Ninety percent of microsurgeons routinely use monitoring devices, with external and laser doppler having achieved greatest popularity. An account is given of the preferred postoperative regimens for flap surveillance, and the overall results are discussed.