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CC BY 4.0 · Arch Plast Surg
DOI: 10.1055/a-2668-3776
Case Report

Adipofascial Flap Monitoring Using Masimo Regional Oximetry: A Case Report and Literature Review on Near-Infrared Spectroscopy for Flap Monitoring

Authors

  • Zhen Luan Low 

    1   Plastic, Reconstructive, and Aesthetic Surgery Service, Sengkang General Hospital, Singapore, Singapore

  • Nadia Hui Shan Sim 

    1   Plastic, Reconstructive, and Aesthetic Surgery Service, Sengkang General Hospital, Singapore, Singapore

  • Allen Wei Jiat Wong 

    1   Plastic, Reconstructive, and Aesthetic Surgery Service, Sengkang General Hospital, Singapore, Singapore

Funding None.
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Abstract

Non-invasive monitoring with near-infrared spectroscopy (NIRS) has not been described in the monitoring of non-cutaneous flaps. We present a 29-year-old female with a traumatic left foot injury, where reconstruction was done with a right free adipofascial anterolateral thigh flap. A Masimo O3™ Regional Oximetry pediatric sensor probe was applied directly over the skin-grafted adipofascial flap for continuous flap monitoring and removed at postoperative day 7 uneventfully. We postulate that NIRS does not necessarily require a skin interface, as measurement depends on tissue thickness and penetration of near-infrared wavelengths. A limitation would be the lack of an optimal threshold for regional tissue oxygenation values, but it is reasonable to adopt a threshold of less than 60% absolute value or more than 20% drop from baseline. NIRS has the potential to monitor non-cutaneous flaps as it can detect deep tissue microvascular changes and provide information on tissue perfusion both accurately and non-invasively.

Keywords

flap monitoring - regional oximetry - near-infrared spectroscopy - adipofascial flap

Contributors' Statement

Z.L.L: Writing—original draft preparation, reviewing, and editing.


N.H.S.S: Conceptualization, reviewing, and editing.


A.W.J.W: Conceptualization, supervision, reviewing, and editing.


All the authors approved the final version of the manuscript.


Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.


Informed Consent

Written informed consent was obtained from the patient for the publication of this case report.




Publication History

Received: 12 December 2024

Accepted: 15 June 2025

Accepted Manuscript online:
30 July 2025

Article published online:
17 January 2026

© 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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