Difference between Capillary Blood Glucose of Free Flap and the Patient: A Novel Objective Marker of Free Flap Vascular Compromise during Postoperative Monitoring

被引:1
作者
Chakraborty, Sourabh Shankar [1 ]
Sahu, Ranjit Kumar [2 ,7 ]
Midya, Manojit [3 ]
Malhotra, Anjana [1 ]
Goel, Akhil Dhanesh [4 ]
Pundhir, Ashish [5 ]
Acharya, Sudeshna [6 ]
机构
[1] South Eastern Railway Cent Hosp, Dept Plast Surg, Kolkata, West Bengal, India
[2] All India Inst Med Sci, Dept Burns & Plast Surg, Bhubaneswar, Odisha, India
[3] Govt Med Coll, Dept Plast Surg, Kota, Rajasthan, India
[4] All India Inst Med Sci, Dept Community Med & Family Med, Jodhpur, Rajasthan, India
[5] All India Inst Med Sci, Dept Community Med, Kolkata, West Bengal, India
[6] Burdwan Med Coll, Dept Trauma & Emergency, Bardhaman, West Bengal, India
[7] All India Inst Med Sci, Dept Burns & Plast Surg, Bhubaneswar 751019, Odisha, India
关键词
free flap; flap monitoring; capillary glucose measurement; objective monitoring;
D O I
10.1055/s-0042-1759726
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background Defining cut-off values of flap glucose levels in diagnosing free flap vascular compromise, without taking patients' glucose levels into account, does not hold good in all circumstances, especially in cases of high fluctuations in patients' capillary blood glucose and in diabetic patients. The aim of our study was to establish the role of capillary blood glucose measurements of the flap in relation to patients' fingertip, as an objective tool for postoperative free flap monitoring. Methods A total of 76 free flaps underwent postoperative monitoring with reference test (clinical parameters) and simultaneously with our index test (difference between capillary blood glucose of free flap and the patient), in non-diabetic and diabetic patients. Patients' demography and flap characteristics were also recorded. An ROC curve was plotted to determine diagnostic accuracy and cut-offs of the index test in diagnosing free flap vascular compromise. Results Our Index test has a cut-off value of 24.5 mg/dL with 68.75% sensitivity and 93% specificity, with an accuracy of 91.54%. Conclusion The difference between capillary blood glucose of free flap and the patient is simple, feasible, and inexpensive, and can be done by any health care professional and does not require any specialized facilities or training. It has an excellent diagnostic accuracy to detect impending free flap vascular compromise, especially in non-diabetics. Although in diabetics, this test becomes less accurate. Being an observer-independent objective test, the difference in capillary blood glucose of patient and flap measurement can be used as a highly reliable tool for postoperative free flap monitoring.
引用
收藏
页码:260 / 266
页数:7
相关论文
共 10 条
  • [1] Diagnostic Accuracy of Blood Glucose Measurements in Detecting Venous Compromise in Flaps
    Bashir, Muhammad Mustehsan
    Tayyab, Zahid
    Afzal, Saira
    Khan, Farid Ahmad
    [J]. JOURNAL OF CRANIOFACIAL SURGERY, 2015, 26 (05) : 1492 - 1494
  • [2] Blood glucose measurement for flap monitoring to salvage flaps from venous thrombosis
    Hara, Hisako
    Mihara, M.
    Iida, T.
    Narushima, M.
    Todokoro, T.
    Yamamoto, T.
    Koshima, I.
    [J]. JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY, 2012, 65 (05) : 616 - 619
  • [3] Ratio of Blood Glucose Level Change Measurement for Flap Monitoring
    Karakawa, Ryo
    Yoshimatsu, Hidehiko
    Narushima, Mitsunaga
    Iida, Takuya
    [J]. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN, 2018, 6 (07)
  • [4] A Simple Way to Measure Glucose and Lactate Values During Free Flap Head and Neck Reconstruction Surgery
    Kishi, Keita
    Ishida, Katsuhiro
    Makino, Yohjiroh
    Miyawaki, Takeshi
    [J]. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, 2019, 77 (01) : 226.e1 - 226.e9
  • [5] medcalc, MedCalc Statistical Software version 19.1.3
  • [6] NELIGAN PC, 1993, MICROSURG, V14, P162
  • [7] A Simplest Method of Flap Monitoring
    Sakakibara, Shunsuke
    Hashikawa, Kazunobu
    Omori, Makoto
    Terashi, Hiroto
    Tahara, Shinya
    [J]. JOURNAL OF RECONSTRUCTIVE MICROSURGERY, 2010, 26 (07) : 433 - 434
  • [8] Glucose, lactate, and pyruvate response in an experimental model of microvascular flap ischemia and reperfusion:: A microdialysis study
    Setälä, LP
    Korvenoja, EML
    Härmä, MA
    Alhava, EM
    Uusaro, AV
    Tenhunen, JJ
    [J]. MICROSURGERY, 2004, 24 (03) : 223 - 231
  • [9] Prospective analysis of flap perfusion by measuring capillary glucose level in flaps
    Sharma, Mukesh Kumar
    Ete, Geley
    Chaturvedi, Gaurav
    Barreto, Elvino
    Doss, Kingsly Paul Meetper
    [J]. EUROPEAN JOURNAL OF PLASTIC SURGERY, 2019, 42 (02) : 119 - 124
  • [10] Vedder NB., 2006, PLAST SURG-CHIR PLAS, V1, P497