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Plastic SurgeryManagement

Free Flap Postoperative Monitoring Protocol

Free Flap Postoperative Monitoring Protocol: Free Flap Postoperative Check → Clinical Examination → Flap Status → Normal Findings → Continue Monitoring.

Interactive Decision Tree

Mini Map

Algorithm Steps

  1. ▶
    Start

    Free Flap Postoperative Check

    1. ●
      Action

      Clinical Examination

      Color, turgor, capillary refill, temperature, Doppler

      1. ◆
        Decision

        Flap Status

        • Normal
        • Arterial compromise
        • Venous congestion
        1. ●
          Action

          Normal Findings

          Pink, warm, brisk refill, audible Doppler

          1. ■
            End

            Continue Monitoring

            Q1h x 24h, then Q2h x 24h

        2. ●
          Action

          Arterial Compromise

          Pale, cool, no refill, absent Doppler

          1. ■
            End

            Urgent OR Exploration

            Remove dressings, explore anastomosis

        3. ●
          Action

          Venous Congestion

          Purple, tense, brisk/excessive refill

          1. ●
            Action

            Leech Therapy Consider

            For venous congestion, explore if no improvement

Guideline Source

ASPS/ASRM Microsurgery Guidelines

DOI: 10.1097/PRS.0000000000007294View Guideline

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

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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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