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

Background: Continuous measurement of flap tissue perfusion in the context of postoperative flap monitoring after microvascular head and neck reconstruction may be confounded by alterations in systemic blood pressure, particularly when using predefined absolute thresholds for the detection of vascular flap compromise. This study aimed to investigate the relationship between radial free forearm flap (RFFF) tissue perfusion and systemic blood pressure following head and neck reconstruction. Methods: The study included 14 patients reconstructed with an RFFF in the head and neck region between 2020 and 2022. Eight hours of postoperatively recorded flap tissue perfusion, determined with an attached surface probe at a 3 mm tissue depth with the Oxygen-2-See (O2C) analysis system, in terms of blood flow and hemoglobin oxygen saturation, and systemic blood pressure, determined as absolute and relative values (difference between measured and preoperative values), in terms of systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial blood pressure (MBP), were analyzed for correlations. Results: Blood flow and hemoglobin oxygen saturation were generally indifferent between the hourly measurement intervals. Blood flow was correlated with relative DBP and MBP values (0.191, p < 0.001; and 0.213, p < 0.001). These correlations persisted upon controlling for norepinephrine, propofol, or sulfentanyl (all p < 0.001). Conclusions: Early postoperative RFFF tissue perfusion measured with attached surface probes for the O2C analysis system remains constant but correlates with systemic blood pressure in terms of blood flow and relative blood pressure values. This highlights the importance of maintaining constant systemic blood pressure during RFFF tissue perfusion measurement for postoperative flap monitoring.

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

Peer-reviewed clinical and outcomes research relevant to medicinal leech therapy and its biology. Indexed in PubMed and verified against the NCBI record.

Explore cómo esta investigación se conecta con la práctica clínica

More peer-reviewed studies in Ensayos clínicos.

• Leech Therapy for Knee Osteoarthritis — The Landmark RCT — Michalsen et al. (2003)
• Leech-Assisted Flap Salvage — Systematic Review of 277 Cases — Whitaker et al. (2012)
• Effects of hirudotherapy on liver functions, lipid profile, and insulin sensitivity in rats with metabolic syndrome — Bilden A et al. (2026)
• HIRUDOTHERAPY IN PRESBYACUZIS PRAECOX IN CLEAN-UP WORKERS AFTER THE CHORNOBYL ACCIDENT DURING THE POST-CATASTROPHE YEARS — Zabolotnyi D, Mishchanchuk N (2019)
• Wound healing potential of bark paste of Pongamia pinnata along with hirudotherapy: A case report — Balasooriya D, Karunarathna C, Uluwaduge I (2021)
• AIF-1 and RNASET2 Play Complementary Roles in the Innate Immune Response of Medicinal Leech — Baranzini N et al. (2019)
• Study on the effect of medicinal leech therapy (Hirudo medicinalis) on full-thickness excisional wound healing in the animal model — Zakian A et al. (2022)
• [Hirudo medicinalis-leech applications in plastic and reconstructive microsurgery--a literature review] — Knobloch K et al. (2007)
• The duration of rest and feeding greatly affects the re-breeding of ectoparasites: Hirudo verbana, Hirudo medicinalis and Hirudo orientalis — Aminov R, Frolov A, Aminova A (2022)
• Recombinant hirudin in clinical practice: focus on lepirudin — Greinacher A, Lubenow N (2001)

Browse all ASH-analysed research →