All Pathways
Plastic SurgeryManagement
Free Flap Postoperative Monitoring Protocol
Free Flap Postoperative Monitoring Protocol: Free Flap Postoperative Check → Clinical Examination → Flap Status → Normal Findings → Continue Monitoring.
Pathway Overview
9 steps
Algorithm Steps
9 total
01Start 02Action Clinical Examination
Color, turgor, capillary refill, temperature, Doppler
03Decision Flap Status
- Normal
- Arterial compromise
- Venous congestion
04Action Normal Findings
Pink, warm, brisk refill, audible Doppler
05End Continue Monitoring
Q1h x 24h, then Q2h x 24h
06Action Arterial Compromise
Pale, cool, no refill, absent Doppler
07End Urgent OR Exploration
Remove dressings, explore anastomosis
08Action Venous Congestion
Purple, tense, brisk/excessive refill
09Action Leech Therapy Consider
For venous congestion, explore if no improvement
- Path rejoins step 07Shared downstream outcome
Guideline Source
ASPS/ASRM Microsurgery Guidelines
Clinical Safety Information
Clinical Decision Support — Not a Substitute for Clinical Judgment
Individual patient factors may require deviation from these recommendations.
Known Limitations
- Clinical exam remains gold standard
- Implantable Doppler aids monitoring
- First 72 hours highest risk period
Applicable Regions
USAUUKEU
UK: Similar intensive monitoring protocols
US: Hourly checks first 24-48h typical
Version 1Next review: 2028-01-01
Next steps
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Related Resources
Frequently Asked Questions
What is the Free Flap Postoperative Monitoring Protocol?
The Free Flap Postoperative Monitoring Protocol is a management clinical algorithm for Plastic Surgery. It provides a structured decision tree to guide clinical decision-making, based on ASPS/ASRM Microsurgery Guidelines.
What guideline is the Free Flap Postoperative Monitoring Protocol based on?
This algorithm is based on ASPS/ASRM Microsurgery Guidelines (DOI: 10.1097/PRS.0000000000007294).
What are the limitations of the Free Flap Postoperative Monitoring Protocol?
Known limitations include: Clinical exam remains gold standard; Implantable Doppler aids monitoring; First 72 hours highest risk period. Individual patient factors may require deviation from these recommendations.
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