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Cevallos et al. Plast Aesthet Res 2023;10:30 Plastic and
DOI: 10.20517/2347-9264.2023.01
Aesthetic Research

Review Open Access

Detecting flap compromise: an updated review of
techniques to monitor microsurgical flaps post-

operatively in breast reconstruction

1,#
5
1,2
Priscila C. Cevallos 1,4,# , Daniel Najafali 1,3,# , Thomas M. Johnstone , Mimi R. Borrelli , Oscar J. Manrique ,
1
Gordon K. Lee , Rahim S. Nazerali 1
1
Division of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Palo Alto, CA
94304, USA.
2
Division of Plastic & Reconstructive Surgery, Department of Surgery, The Warren Alpert Medical School of Brown University,
Providence, RI 02903, USA.
3
Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA.
4
Geisel School of Medicine, Dartmouth University, Hanover, NH 03755, USA.
5
Division of Plastic & Reconstructive Surgery, Department of Surgery, Strong Memorial Hospital, University of Rochester Medical
Center, Rochester, NY 14642, USA.
#
Authors contributed equally.
Correspondence to: Dr. Rahim S. Nazerali, Division of Plastic & Reconstructive Surgery, Stanford University School of Medicine,
770 Welch Road, Suite 400, Palo Alto, CA 94304, USA. E-mail: rahimn@stanford.edu
How to cite this article: Cevallos PC, Najafali D, Johnstone TM, Borrelli MR, Manrique OJ, Lee GK, Nazerali RS. Detecting flap
compromise: an updated review of techniques to monitor microsurgical flaps post-operatively in breast reconstruction. Plast
Aesthet Res 2023;10:30. https://dx.doi.org/10.20517/2347-9264.2023.01
Received: 5 Jan 2023 First Decision: 18 May 2023 Revised: 31 May 2023 Accepted: 13 Jun 2023 Published: 21 Jun 2023

Academic Editor: Christine Hsu Rohde Copy Editor: Yanbing Bai Production Editor: Yanbing Bai

Abstract
Breast reconstructive surgery utilizing free tissue transfer has revolutionized the restoration of aesthetic and
functional outcomes for patients. Even for the most routine free flap procedures, substantial hospital resources and
costs are necessary. The effectiveness of free flap surgery, along with any reconstructive procedure, hinges upon
meticulous patient selection, thorough pre-operative planning, well-informed peri-operative decision-making, and
diligent post-operative monitoring and care for the patient. This article presents a review of standard clinical care
monitoring techniques during the post-operative period, as well as the diverse strategies currently employed for
post-operative flap monitoring.

Keywords: Flap monitoring, flap salvage, peri-operative monitoring, post-operative monitoring

© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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