Smart Phone Photography as a Reliable Adjunct in Free Flap Monitoring: An Experience from a South Indian Post-Graduate Training Institute – Original Reasearch

Original Research

Abstract

Objectives:

Postoperative free flap monitoring is crucial as early detection of flap compromise and intervention can substantially increase the flap survival rate. Primary observers of free flap in recovery room is different dependent on the on-duty resident in most of the teaching institutions. A standardized free flap surgical protocol and postoperative monitoring is essential in these circumstances.

Methods:

10 patients who underwent free flap reconstruction for oral cavity cancer ablative surgery using our standard patient section, pre-operative assessment, surgical protocol were included in this study. Post operatively, along with the clinical assessment of flap, smartphones were used to capture flap photos under standard lighting conditions and real time assessment was done using a WhatsApp messenger group by sending it to the operating surgeons and residents.  The photos were assessed for any colour or texture change and in case of any flap compromise, patient was taken back to operation room without any delay.

Results:

Our protocol helped in reducing the time interval between identification of the flap compromise and re-exploration, which is the one important factor for flap survival. The flap taken for re-exploration in our study group was salvaged successfully.

Conclusion:

We suggest a cost-effective, simple and less time consuming multidisciplinary free flap monitoring protocol using smart phone photography and a messenger for evaluation by the operating team and the residents would be an effective method along with clinical monitoring for substantially increasing the success of free flap salvage rates especially in a teaching institution.