American Society of Hirudotherapy

Advances in flap monitoring and impact of enhanced recovery protocols

Research article published in Journal of surgical oncology (2018)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewClinical TrialsKarinja et al. · Journal of surgical oncology, 2018

Abstract

Recent advances in technology have shown promise in improving outcomes in microsurgery. Although vascular compromise and flap loss represent major complications, flap monitoring techniques have evolved to improve rates of salvage. Enhanced recovery protocols have also been adapted to expedite patient recovery and length of stay. Early studies have shown benefits such as decreased complications and costs and improved patient outcomes. This review examines the current literature on these topics in the setting of microsurgery.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleReview
Indexed MeSH termsCritical PathwaysDiagnostic ImagingFree Tissue FlapsGraft RejectionHumansMicrodialysisMicrosurgeryMonitoring, PhysiologicOximetryRegional Blood FlowSpectroscopy, Near-Infrared

Summary

Peer-reviewed clinical and outcomes research relevant to anticoagulation, leech therapy, and microsurgical flap management. Indexed in PubMed and verified against the NCBI record.

Why This Matters for Hirudotherapy

This article reviews the current literature on flap-monitoring techniques and enhanced recovery protocols in microsurgery, noting that vascular compromise and flap loss are major complications, that monitoring methods have evolved to improve flap-salvage rates, and that enhanced recovery protocols have been associated in early studies with fewer complications, lower costs, and improved outcomes. For hirudotherapy it provides useful framing of the microsurgical context, where leech therapy is a recognized adjunct for managing venous congestion in failing flaps and where early detection of vascular compromise governs salvage decisions. As a caveat, this is a narrative review summarizing other studies rather than original data, it does not specifically evaluate medicinal-leech therapy, and the abstract describes the supporting evidence as early-stage.

Citation

Advances in flap monitoring and impact of enhanced recovery protocols.

Karinja et al. · Journal of surgical oncology, 2018

DOI

Added to ASH library: May 28, 2026 · Site last updated: June 18, 2026

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