CMC Vellore, India
Posters & Accepted Abstracts: Surgery Curr Res
Background: Postoperative monitoring of flap is equally important as harvesting a flap. Early diagnosis of flap failure can salvage the flap by appropriate intervention. Monitoring method should be rapid, inexpensive and accurate. The purpose of this study is to evaluate that the Blood Glucose Monitoring (BGM) of the flap can meet our monitoring requirement or not. Methods: This study includes 60 flaps monitoring by measuring their interstitial glucose level by pricking the distal end of the flap. Out of 60 flaps, 28 were free flaps, 23were pedicles and rest were a random flap. Quantitative data were expressed in frequency and percentage. Data were expressed as mean value and standard deviation for capillary glucose level of the flap. Result: Out of 60 flaps 44 survived well, 10 flaps were having minor distal necrosis (<10% of flap length), major flap necrosis occurred in 3 flaps while 3 flaps failed completely. Failed flaps have shown low glucose level. Using ROC (Receiver operating characteristic curve) cut off value for BGM was 61mg/dl, with a sensitivity of 93% and specificity of 80%. Conclusion: Blood glucose monitoring of flap gives an idea about the perfusion of the flap in the postoperative period. Flap capillary glucose levels less than 61 mg/dl is suggestive of ischemia of flap with sensitivity and specificity of 93% and 80 % respectively. It allows early detection of vascular compromise has prognostic value and also defines a line of demarcation in partial necrosis.