Near-Infrared Spectroscopy for Continuous Noninvasive Monitoring of Free Flap in Head and Neck Reconstruction: Systematic Review of the Literature and Personal Experience
Case report published in Surgical innovation (2023)
Abstract
BACKGROUND: Buried free flaps represent a reconstructive challenge concerning monitoring of vitality, which is fundamental for an early detection of flap failure and prompt surgical salvage. Many flap monitoring techniques have been developed over time, and there is still no consensus concerning the best monitoring technique for buried reconstructions. METHODS: We performed a systematic review of the literature on NIRS monitoring for head and neck free flaps. Moreover, we presented a case of orbital reconstruction through a buried free myo-fascial anterolateral tight flap (ALTF) in which postoperative monitoring was performed by means of NIRS. RESULTS: Four studies were included with a total of 200 monitored head and neck free flap reconstructions. Flap survival was reported in 96.5% of studies (n = 193/200) with a 3.5% of total flap failure rate (n = 7/200). We monitored the buried myo-fascial ALTF for 7 post-operative days measuring a regional oxygen saturation (rSO2) ranging from 55% to 72% (mean = 66%). CONCLUSIONS: This device appeared to be an efficient choice for monitoring buried flaps, thanks to its ability to measure tissue perfusion deep under the skin, to the continuous availability of recorded data on the monitor, and to its low impact on the patient. Further prospective studies are advised in order to standardize this monitoring technique and define warning values.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Buried free flaps represent a reconstructive challenge concerning monitoring of vitality, which is fundamental for an early detection of flap failure and prompt surgical salvage.
Por qué esto importa para la hirudoterapia
Esta revisión sistemática de la monitorización mediante NIRS para colgajos libres de cabeza y cuello incluyó cuatro estudios que abarcaron 200 reconstrucciones monitorizadas con una tasa de supervivencia del colgajo del 96,5% (193/200) y una tasa de fallo total del 3,5% (7/200), complementada con el caso propio de los autores de reconstrucción orbitaria con un colgajo anterolateral de muslo miofascial enterrado monitorizado durante 7 días postoperatorios que mostró valores de rSO2 del 55–72% (media del 66%). Los autores concluyen que la NIRS es una opción eficiente para la monitorización de colgajos enterrados debido a su capacidad de penetración en tejidos profundos, la disponibilidad continua de datos y su bajo impacto en el paciente. Para el dominio de ASH, la relevancia es indirecta: la monitorización de colgajos libres se relaciona con la cirugía reconstructiva donde las sanguijuelas pueden abordar la congestión venosa, pero esta revisión no menciona sanguijuelas, hirudoterapia ni anticoagulación. La salvedad es que se trata de una revisión de tecnología de monitorización sin contenido relacionado con sanguijuelas.
Citación
Near-Infrared Spectroscopy for Continuous Noninvasive Monitoring of Free Flap in Head and Neck Reconstruction: Systematic Review of the Literature and Personal Experience
Festa BM et al. · Surgical innovation, 2023
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026