BMC Ear, Nose and Throat Disorders

Background: Early identification of flap failure is an indispensable prerequisite for flap salvage. Although many technical developments of free flap monitoring have now reached clinical application, very few are considered to be reliable and non-invasive for early recognition of flap failure. Case presentation: We used microendoscopic technique for microvascular monitoring of free autologous jejunal flap by the direct visualisation of the flow of erythrocytes through the capillary vasculature on both the mucosal and serosal surfaces. Blood flow was seen to be pulsatile, with individual erythrocytes visible in the capillaries. The best view was obtained when the scope was focussed directly on the capillary rather than the graft surface. The view of the unstained mucosal surface was bland apart from the fine capillary loops which were seen to fill with each pulsatile event. The microendoscopic examination of the serosal surface revealed much larger calibre vessels with obvious blood flow. Conclusion: The microendoscopic monitoring technique is simple and safe with direct visualisation of blood flow. The technique may also be useful for the monitoring of other free bowel transplants. Background Tissue oxygenation and maintenance of microvascular blood flow in grafted tissues are crucial for flap viability. Early identification of flap failure is a precondition of flap salvage and therefore important for flap prognosis [1]. Although many technical developments of free flap monitoring have now reached clinical application, very few are considered to be reliable and non-invasive for early recognition of flap failure [2]. Therefore, reliable monitoring of free microvascular tissue flaps would be a valuable new tool for clinicians [3,4]. Non-invasive monitoring techniques are procedures of little or no morbidity that may be repeated frequently to Published: 29 September 2006 BMC Ear, Nose and Throat Disorders 2006, 6:14 doi:10.1186/1472-6815-6-14 Received: 16 July 2006 Accepted: 29 September 2006 This article is available from: http://www.biomedcentral.com/1472-6815/6/14 © 2006 Upile et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.