Flap monitoring of the H & N reconstruction with free flap

초록

Head and neck cancer is very common cancer in worldwide and squamous cell carcinoma is a most common. Functional reconstruction after tumour resection of head and neck remains a clinical challenge and free vascularized tissues provide powerful reconstructive options for reconstruction. The successful result of free flap is important to enhance a functional and cosmetical outcome after reconstructive surgery. In case of flap failure, it comes to a very stressful condition both of a reconstruction surgeon and patient and causes to increase the hospital stay of patient`s and medical cost. Therefore, flap monitoring after H & N cancer reconstruction becomes a very important tool for evaluation of free flap. Flap monitoring of exposed and accessible areas could be direct observed is evaluated with subjective monitoring methods such as capillaries refilling, skin colors, and skin turgor. And objective methods such as doppler monitoring, implantable vessel doppler, and plethysmography could be useful for monitoring of the free flap. However, flap monitoring in areas where direct observation is difficult, such as the esophagus or hypopharynx, has limitations for flap monitoring. In particular, the area where could be direct observed, has a problem for free flap monitoring because the intraoral space is always moisture condition by saliva and mucous secreation.After reconstruction of H&N cancer, surgeons evaluate the circulation status of free flap based on various subjective, objective methods and personal experiences. The author also uses free flap monitoring using various known methods, and sometimes use temperature monitoring with personal experience method. Therefore, I would like to introduce my method using temperature monitoring with personal experience. And I want to discuss about the interpretation of the result of monitoring, the monitoring method of your method with our experience