SMARTPHONE PHOTOGRAPHY AND WIRELESS INTERNET FOR FREE FLAP MONITORING
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2019, Vol 8, Issue 5
Abstract
BACKGROUND Fate of the microvascular free flaps (MFF) is directly related to the surgeon’s skill and experience, diligent postoperative monitoring, and re-exploration at the earliest to salvage the failing flap. In keeping with the times, smartphone photography and wireless technologies may have a role to play alongside the other methods to monitor MFFs. MATERIALS AND METHODS In this pilot study, we assessed the feasibility of utilizing smartphone and wireless Internet technologies for postoperative monitoring of MFFs (with a visible skin paddle) for the oral cancer post-extirpation defects. Post-operative photographs of MFFs were sent to two surgeons using smartphones and wireless Internet technology every six hours for 120 hours. Clinical and photographic methods of monitoring were compared between the findings of three surgeons. The operating surgeon (OPS) and the observing surgeon-2 (ObS-2) had access to clinical monitoring records, while the photographs were available to the OPS and the observing surgeon-1 (ObS-1). Indications to re-explore and salvage rates were compared using standard statistical methods. RESULTS 30 MFFs were studied, with 100% survival rate at 120 hours. 5 patients were re-explored and salvaged completely. Re-exploration was indicated for the neck hematoma of 4 patients, and post-anastomotic venous thrombosis of 1 patient in whom the venous congestion was identified on a photograph. The accuracy rate with the use of photographs was 100%. CONCLUSION Smartphone photography with wireless Internet technology has proven to be a useful adjunct in free flap monitoring with a success rate of 100% in identifying a venous thrombosis and salvaging the flap. Incorporating this technique in the current protocols of free flap monitoring may help in identifying impending flap failures.
Authors and Affiliations
Vasanth Mark Samuel, Pranay Gaikwad, Cecil T. Thomas, Sridharamurthy A.
Keywords
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- EP ID EP554734
- DOI 10.14260/jemds/2019/72
- Views 91
- Downloads 0
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