Use of Handheld Ultrasound for Flap Monitoring after Free Jejunal Transfer

Abstract

Monitoring blood flow in a buried flap is often challenging. In cases of free jejunal transfer, although exteriorization of a minor jejunal segment has become the standard method, there remain issues such as intestinal fluid management, the need for separation of the monitored jejunum, and high false positive rates. In this study, we performed monitoring using handheld ultrasound (Vscan Extend™; GE Healthcare, Japan) in four patients who had undergone free jejunal transfer between August 2022 and December 2022. The blood flow in the anastomosed vessels and the peristalsis of the jejunum were observed in all patients. There were no cases of reoperation due to early failure such as thrombosis of vascular anastomosis or vessel spasm. The handheld ultrasound made it possible to adequately evaluate both the blood flow in the anastomosed vessels and the peristalsis of the transplanted jejunum. Handheld ultrasound can be useful for monitoring blood flow in a buried flap.

Keywords

• free jejunal transfer
• ultrasound
• handheld
• color doppler
• flap monitoring
• head and neck
• microsurgery