Flap Blood Glucose Level for Monitoring Flap Survival
Abstract
Flap surgery represents a cornerstone of modern reconstructive procedures, enabling the transfer of vascularized tissue units to restore form and function in complex defects. The evolution of flap techniques traces back to early pedicled flaps used for nasal reconstruction, progressing through axial-pattern designs in the mid-20th century and culminating in the advent of microsurgical free tissue transfer. Flaps are classified according to blood supply, tissue composition, anatomical location, and method of transfer, ranging from local random-pattern flaps to intricate free flaps relying on microvascular anastomosis. Despite high success rates, vascular complications such as arterial insufficiency and venous congestion remain the leading causes of flap failure. Consequently, effective monitoring is critical for early detection and timely intervention. Traditional methods clinical examination, temperature assessment, and Doppler ultrasonography remain the standard, yet newer biochemical and sensor-based techniques have emerged to enhance accuracy. Among these, blood glucose monitoring offers a promising, objective indicator of tissue perfusion and metabolic integrity. Decreases in flap glucose levels precede visible ischemic changes, enabling early salvage interventions. Integration of glucose monitoring with microdialysis, near-infrared spectroscopy, and advanced sensor technologies may further optimize postoperative outcomes. Future research should focus on standardizing glucose thresholds, validating sensor systems, and applying AI-based predictive algorithms to improve flap survival and patient recovery.