REMOTE REAL-TIME MONITORING OF FREE FLAPS VIA SMARTPHONE PHOTOGRAPHY AND 3G WIRELESS INTERNET: A PROSPECTIVE STUDY EVIDENCING DIAGNOSTIC ACCURACY

This prospective study was designed to compare the accuracy rate between remote smartphone photographic assessments and in-person examinations for free flap monitoring. One hundred and three consecutive free flaps were monitored with in-person examinations and assessed remotely by three surgeons (Team A) via photographs transmitted over smartphone. Four other surgeons used the traditional in-person examinations as Team B. The response time to re-exploration was defined as the interval between when a flap was evaluated as compromised by the nurse/house officer and when the decision was made for re-exploration. The accuracy rate was 98.7% and 94.2% for in-person and smartphone photographic assessments, respectively. The response time of 8 +/- 3 min in Team A was statistically shorter than the 180 +/- 104 min in Team B (P = 0.01 by the Mann-Whitney test). The remote smartphone photography assessment has a comparable accuracy rate and shorter response time compared with in-person examination for free flap monitoring. (C) 2011 Wiley Periodicals, Inc. Microsurgery 31: 589-595, 2011.