Post operative monitoring of free flap tissue perfusion is vital. Devices available are expensive and complex to operate. Most surgeons rely on direct clinical observation. A monitoring system that is reliable, inexpensive, and easy to operate is needed.
Using mobile phone technology, the authors developed and evaluated a new free flap monitoring system: SilpaRamanitor.
The software was developed for Android-operated mobile phones. Forty-two normal subjects were recruited to assess its effectiveness.
Varying degrees of pressure were applied around the index finger to produce partial venous occlusion, partial arterial occlusion, complete venous occlusion, and complete arterial occlusion sequentially.
Photographs of each subject’s index and middle fingers were taken using the smartphone camera.
To detect the abnormal perfusion presented on the index finger, the application was instructed to analyse photographs for colour difference, with the un-occluded middle finger serving as the control.
The sensitivity, specificity, accuracy, false-negative results and false-positive results were 94, 98, 95, 6 and one per cent, respectively. The accuracy of the application in grading occlusion severity was also evaluated. Thirty-nine cases (93 per cent) were correctly identified as venous occlusion.
The occlusion severity was correctly identified in 33 cases (85 per cent). Likewise, for the 40 cases (95 per cent) correctly identified as arterial occlusion, the method correctly categorised its severity in 33 cases (83 per cent).
The authors developed a new, accurate and reliable diagnostic system for postoperative microsurgery monitoring using a smartphone application. SilpaRamanitor is inexpensive and easy to use, making it applicable in many microsurgical settings.
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