scholarly journals 507 Quantifying the Limitations of Clinical and Technology-Based Flap Monitoring Strategies Using A Systematic Recurrent Themes Analysis

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
R Kwasnicki ◽  
A Noakes ◽  
N Banhidy ◽  
S Hettiaratchy
Keyword(s):  
Systematic Review ◽  
Free Flap ◽  
Final Analysis ◽  
Eligibility Criteria ◽  
Discussion Section ◽  
Monitoring Techniques ◽  
Free Flap Monitoring ◽  
Flap Viability ◽  
Senior Clinician ◽  
Flap Monitoring

Abstract Aim Multiple techniques exist to monitor free flap viability postoperatively, varying with practical and personal preference, yet the limitations of each technique remain unquantified. This systematic review aims to identify the most commonly reported limitations of these techniques in clinical practice. Method A systematic review was conducted according to PRISMA guidelines using MEDLINE, EMBASE and Web of Science with search criteria for postoperative free flap monitoring techniques. Search results were independently screened using defined criteria by two authors and a senior clinician. Limitations of the techniques found in the discussion section of eligible papers were recorded and categorised using recurrent theme analysis. Results A total of 4826 records were identified. 4643 articles met the eligibility criteria and were subsequently reviewed, with 195 papers included in the final analysis. The most frequently reported limitations of clinical monitoring were interpretation requiring expertise (25% of related papers), unsuitability for buried flaps (21%), and lack of quantitative/objective values (19%). For non-invasive technologies: lack of quantitative/objective values (21%), cost (16%) and interpretation requiring expertise (13%). For invasive technologies: application requiring expertise (25%), equipment design and malfunction (13%) and cost (13%). Conclusions This is the first systematic review to quantify the limitations of different flap monitoring techniques as reported in the literature. The limitations identified better inform clinicians to decide the best single or combined monitoring approach for their practice and aid development in new flap monitoring technologies.

scholarly journals Postoperative Free-Flap Monitoring Techniques

2019 ◽  
Vol 33 (01) ◽  
pp. 013-016 ◽  
Author(s):  
Scott Kohlert ◽  
Alexandra Quimby ◽  
Masoud Saman ◽  
Yadranko Ducic
Keyword(s):  
Free Flap ◽  
Free Tissue Transfer ◽  
Potential Complication ◽  
Postoperative Monitoring ◽  
Monitoring Techniques ◽  
Flap Failure ◽  
Tissue Transfer ◽  
Free Flap Monitoring ◽  
Flap Monitoring

AbstractFree tissue transfer is commonly employed in the reconstruction of large or complicated defects. Postoperative flap failure from microvascular compromise is an uncommon but major potential complication of this procedure. As such, many postoperative monitoring techniques devices have been developed. This paper provides an overview of the wide variety of options available for surgeons today.

Review of Flap Monitoring Technology in 2020

2020 ◽  
Vol 36 (06) ◽  
pp. 722-726
Author(s):  
Adam Jacobson ◽  
Oriana Cohen
Keyword(s):  
Head And Neck ◽  
Free Flap ◽  
Loss Rate ◽  
Early Recognition ◽  
Postoperative Patient ◽  
Free Flap Monitoring ◽  
Improved Outcomes ◽  
Vascular Compromise ◽  
Flap Monitoring ◽  
Multiple Levels

AbstractAdvances 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.

Current Approaches to Free Flap Monitoring

2014 ◽  
Vol 34 (2) ◽  
pp. 52-56 ◽  
Author(s):  
Albert H. Chao ◽  
Susan Lamp
Keyword(s):  
Free Flap ◽  
Free Flap Monitoring ◽  
Flap Monitoring

scholarly journals Reply: Refinements in Postoperative Free Flap Monitoring

2011 ◽  
Vol 127 (6) ◽  
pp. 2512
Author(s):  
Jeroen M. Smit ◽  
Clark J. Zeebregts ◽  
Rafael Acosta ◽  
Paul M. N. Werker
Keyword(s):  
Free Flap ◽  
Free Flap Monitoring ◽  
Flap Monitoring

New prospects in postoperative free flap monitoring

2011 ◽  
Vol 40 (10) ◽  
pp. 1149
Author(s):  
B. Henault ◽  
A. Duvernay ◽  
M. Roche ◽  
N. Zwetyenga
Keyword(s):  
Free Flap ◽  
Free Flap Monitoring ◽  
Flap Monitoring

scholarly journals Impact of non-menthol flavours in e-cigarettes on perceptions and use: an updated systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031598 ◽  
Author(s):  
Clare Meernik ◽  
Hannah M Baker ◽  
Sarah D Kowitt ◽  
Leah M Ranney ◽  
Adam O Goldstein
Keyword(s):  
Systematic Review ◽  
Risk Perceptions ◽  
Longitudinal Research ◽  
Age Groups ◽  
Experimental Studies ◽  
Final Analysis ◽  
Eligibility Criteria ◽  
Product Appeal ◽  
The Impact

ObjectivesGiven the exponential increase in the use of e-cigarettes among younger age groups and in the growth in research on e-cigarette flavours, we conducted a systematic review examining the impact of non-menthol flavoured e-cigarettes on e-cigarette perceptions and use among youth and adults.DesignPubMed, Embase, PyscINFO and CINAHL were systematically searched for studies published and indexed through March 2018.Eligibility criteriaQuantitative observational and experimental studies that assessed the effect of non-menthol flavours in e-cigarettes on perceptions and use behaviours were included. Specific outcome measures assessed are appeal, reasons for use, risk perceptions, susceptibility, intention to try, initiation, preference, current use, quit intentions and cessation.Data extraction and synthesisThree authors independently extracted data related to the impact of flavours in tobacco products. Data from a previous review were then combined with those from the updated review for final analysis. Results were then grouped and analysed by outcome measure.ResultsThe review included 51 articles for synthesis, including 17 published up to 2016 and an additional 34 published between 2016 and 2018. Results indicate that non-menthol flavours in e-cigarettes decrease harm perceptions (five studies) and increase willingness to try and initiation of e-cigarettes (six studies). Among adults, e-cigarette flavours increase product appeal (seven studies) and are a primary reason many adults use the product (five studies). The role of flavoured e-cigarettes on smoking cessation remains unclear (six studies).ConclusionThis review provides summary data on the role of non-menthol flavours in e-cigarette perceptions and use. Consistent evidence shows that flavours attract both youth and adults to use e-cigarettes. Given the clear findings that such flavours increase product appeal, willingness to try and initiation among youth, banning non-menthol flavours in e-cigarettes may reduce youth e-cigarette use. Longitudinal research is needed to examine any role flavours may play in quit behaviours among adults.

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