How Microvascular Reconstructive Surgery Is An Effective...

Microvascular reconstructive flap surgery is an effective way for the medical team to improve the appearance or functionality of a surgical or existing tissue defect. Microvascular free tissue transfers, or free flaps, are monitored for arterial and venous insufficiency for several days during the post-operative period. The gold standard for flap monitoring includes the clinical inspection of color, capillary refill, temperature, and turgor of the transplanted tissue involved. Due to limited alternative reconstructive options available to patients, accurate and timely flap assessments are critical to the viability of the flap. Unfortunately post-operative complications are sometimes unavoidable, however monitoring by a trained clinician is associated with early flap salvage rates that in turn improve patient care outcomes (Salgado, Chim, Shoenoff, Mardini, 2010). This performance improvement proposal explores the efficiency and accuracy of using telemedicine as an adjunct method of free flap monitoring comparted to traditional methods. This proposal will discuss the relevance of using digital photographs and internet technology as a means to improve response times between the nurse and the primary plastic surgeon that increase salvage rates of ischemic flaps. Conclusive findings from two studies involving 200 free flaps indicate that digital photographs and smart phone communication resulted timely intervention by the plastic that contributed to the success of flap