Current evidence for postoperative monitoring of microvascular free flaps: a systematic review.
Review published in Annals of plastic surgery (2015)
Abstract
BACKGROUND: Despite a plethora of monitoring techniques reported in the literature, only a small number of studies directly address clinical relevant end points, such as the flap salvage rate and false-positive rate. METHOD: We conducted a systematic review of current evidence regarding the postoperative monitoring of microvascular free-tissue transfer via extensive electronic and manual search and perusing databases, such as PubMed, Cochrane, American College of Physicians (ACP) Journal Club, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Excerpta Medica Database (EMBASE), and Ovid MEDLINE. The included literature (n = 184 publications) was critically appraised using March 2009 Oxford Centre for Evidence-Based Medicine definitions, focusing on the evidence for the efficacy of each technique in improving the flap salvage rate of compromised flaps. RESULT: There is a paucity of outcome-based studies, with only implanted Doppler probes, near-infrared spectroscopy, laser Doppler flowmetry, quantitative fluorimetry, and digital photography assessment using smartphones having been demonstrated in comparative studies to improve flap salvage rate. Currently, the implantable Doppler probe is the technique with the largest number of comparative studies and case series to demonstrate its effectiveness compared with clinical monitoring. CONCLUSIONS: Future studies need to evaluate the most promising monitoring techniques further with a focus on assessing clinically relevant outcomes, such as the flap salvage rate and the false-positive rate, and not simple clinical series reporting patient and physician satisfaction.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Despite a plethora of monitoring techniques reported in the literature, only a small number of studies directly address clinical relevant end points, such as the flap salvage rate and false-positive rate. We conducted a systematic review of current evidence regarding the postoperative monitoring of...
Por qué esto importa para la hirudoterapia
Esta revisión sistemática evaluó la evidencia sobre las técnicas de monitorización postoperatoria de los colgajos libres microvasculares a lo largo de 184 publicaciones, identificando las sondas Doppler implantadas, la espectroscopia de infrarrojo cercano, la flujometría Doppler láser, la fluorimetría cuantitativa y la fotografía digital basada en teléfonos inteligentes como técnicas con evidencia comparativa para mejorar las tasas de rescate de colgajos. El resumen no contiene ninguna mención de sanguijuelas, hirudina o hirudoterapia, y no puede establecerse ninguna conexión defendible con el ámbito de ASH a partir del estudio tal como se describe. Matiz: los autores señalan una escasez de estudios basados en desenlaces y solicitan investigación futura centrada en desenlaces clínicamente relevantes, como las tasas de rescate de colgajos y de falsos positivos; la relevancia para la hirudoterapia es nula.
Citación
Current evidence for postoperative monitoring of microvascular free flaps: a systematic review.
Chae et al. · Annals of plastic surgery, 2015
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 28, 2026 · Última actualización del sitio: 18 de junio de 2026