Abstract
Advances in free flap reconstruction of complex head and neck defects have allowed
for improved outcomes in the management of head and neck cancer. Technical refinements
have decreased flap loss rate to less than 4%. However, the potential for flap failure
exists at multiple levels, ranging from flap harvest and inset to pedicle lay and
postoperative patient and positioning factors. While conventional methods of free
flap monitoring (reliant on physical examination) remain the most frequently used,
additional adjunctive methods have been developed. Herein we describe the various
modalities of both invasive and noninvasive free flap monitoring available to date.
Still, further prospective studies are needed to compare the various invasive and
noninvasive technologies and to propel innovations to support the early recognition
of vascular compromise with the goal of even greater rates of flap salvage.
Keywords
flap monitoring - implantable Doppler - flap salvage
