ArticleJPRAS open2026
Comparison of flap and contralateral donor site tissue perfusion for flap monitoring in microvascular head and neck reconstruction - a retrospective study.
Article in JPRAS open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Postoperative flap monitoring in microvascular head and neck reconstruction based solely on flap tissue perfusion measurements relative to predefined thresholds may be influenced by systemic tissue perfusion alterations. This study compared flap and contralateral donor site tissue perfusion and evaluated the utility of the flap-to-donor site ratio in detecting vascular flap compromise. Materials & methods: Tissue perfusion measured with the O2C analysis system at a tissue depth of 3 mm at 0, 12, 24, 36, and 48 h postoperatively was retrospectively analyzed in 62 patients who underwent head and neck reconstruction with a fasciocutaneous free flap (FFF) (radial free forearm flap) or a perforator free flap (PFF) (anterolateral thigh flap or fibula free flap) between 2020 and 2022. Flap and contralateral donor site tissue perfusion parameters (blood flow, hemoglobin concentration, and hemoglobin oxygen saturation) were compared, and flap-to-donor site ratio cut-off values indicating vascular flap compromise, based on the minimum (blood flow and hemoglobin oxygen saturation) or maximum (hemoglobin concentration) value of all 5 measurement timepoints, were determined. Results: Blood flow, hemoglobin concentration, and hemoglobin oxygen saturation were in general higher at the flap than the donor site ( Conclusion: The postoperative course of tissue perfusion differs between flap and contralateral donor sites in FFFs and PFFs. The flap-to-donor site ratio could be used to detect vascular flap compromise in microvascular head and neck reconstruction, with further studies needed to confirm the determined cut-off values for the flap-to-donor site ratio indicating vascular flap compromise.
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