ArticlePlastic and reconstructive surgery. Global open2021
Quantifying the Limitations of Clinical and Technology-based Flap Monitoring Strategies using a Systematic Thematic Analysis.
Article in Plastic and reconstructive surgery. Global open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- Effect of intravenously administered norepinephrine on early postoperative tissue perfusion of radial free forearm flaps in the head and neck region - retrospective analysis in the context of continuous flap monitoring.BMC anesthesiology · 2026Article
- Article
- Using a Large Language Model to Support Thematic Analysis of Patient Experiences in Chronic Illness Management: Comparative Qualitative Study.Journal of medical Internet research · 2026Article
- Adipofascial Flap Monitoring Using Masimo Regional Oximetry: A Case Report and Literature Review on Near-Infrared Spectroscopy for Flap Monitoring.Archives of plastic surgery · 2026Article
- Article
- Autonomization of Microvascular Free Flaps in Reconstructive Surgery: A Narrative Review.Microsurgery · 2026Review
- AETHER: Video-Based Smartphone Free Flap Monitoring Using Spatial Phase Coherence and Reference-Corrected Augmented Imaging.Computational and structural biotechnology journal · 2026Article
- Continuous Measurement of Radial Free Forearm Flap Tissue Perfusion for Flap Monitoring After Microvascular Head and Neck Reconstruction-Systemic Blood Pressure as a Potential Confounder in the Early Postoperative Period.Journal of clinical medicine · 2025Article
- The future of free flap monitoring by laser continuous doppler flowmetry: A prospective assessment in consecutive 71 patients.JPRAS open · 2025Article
- Application of pedicled supraclavicular flaps in hypopharyngectomy with preservation of laryngeal function.BMC surgery · 2024Article
- Imaging Photoplethysmography (iPPG) in Head and Neck Reconstructive Surgery: A Novel Technique for Noninvasive Flap Perfusion Monitoring.Lasers in surgery and medicine · 2024Article
- Development of an Automated Free Flap Monitoring System Based on Artificial Intelligence.JAMA network open · 2024Article
- Superb Microvascular Imaging at Evaluation of Nonvisible Buried De-epitelized Flap Vascularization in Breast Reconstruction.The Eurasian journal of medicine · 2023Article
- Role of Lactate Measurement in Flap Monitoring: An Useful Adjunct.Indian journal of plastic surgery : official publication of the Association of Plastic Surgeons of India · 2023Article
- Free flaps monitoring by Laser-Doppler Flowmetry in head and neck surgery.Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale · 2022Article
- Comparison of Hyperspectral Imaging and Microvascular Doppler for Perfusion Monitoring of Free Flaps in an In Vivo Rodent Model.Journal of clinical medicine · 2022Article
- Fingerstall-type Tissue Oximetry Reduced Anxiety of Nurses in Postoperative Nursing Monitoring of Free Flaps.Plastic and reconstructive surgery. Global open · 2021Article
- New Approach to the Old Challenge of Free Flap Monitoring-Hyperspectral Imaging Outperforms Clinical Assessment by Earlier Detection of Perfusion Failure.Journal of personalized medicine · 2021Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMultiple techniques exist to monitor free flap viability postoperatively, varying with practical and personal preference, yet the limitations of each technique remain unquantified. This systematic review aims to identify the most commonly reported limitations of these techniques in clinical practice.
methodsA systematic review was conducted according to PRISMA guidelines using MEDLINE, EMBASE, and Web of Science with search criteria for postoperative free flap monitoring techniques. Search results were independently screened using defined criteria by two authors and a senior clinician. Limitations of the techniques found in the discussion section of eligible articles were recorded and categorized using thematic analysis.
resultsA total of 4699 records were identified. In total, 2210 articles met the eligibility criteria and were subsequently reviewed, with 195 papers included in the final analysis. The most frequently reported limitations of clinical monitoring were interpretation requiring expertise (25% of related papers), unsuitability for buried flaps (21%), and lack of quantitative/objective values (19%). For noninvasive technologies, the limitations were lack of quantitative/objective values (21%), cost (16%), and interpretation requiring expertise (13%). For invasive technologies, the limitations were application requiring expertise (25%), equipment design and malfunction (13%), and cost (13%).
conclusionsThis is the first systematic review to quantify the limitations of different flap monitoring techniques, as reported in the literature. This information may enhance the choice in monitoring strategy for a reconstructive service, and inform the development and refinement of new flap monitoring technologies.
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