Akhila, S (2015) Application of Smartphone Photography and 3G Wireless Internet Technology in Free Flap Monitoring: A Prospective Study. Masters thesis, Christian Medical College, Vellore.
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Abstract
AIMS OF THE STUDY: 1. To study the role of Smartphone photography and 3G wireless technology for monitoring free flap. OBJECTIVES: 1. To study the feasibility of Smartphone photography in free flap monitoring. 2. To study the feasibility of Smartphone photography and 3G wireless internet technology in monitoring free flaps. MATERIALS AND METHODS: The feasibility of using Smartphone technology and 3G wireless internet technology as an adjunct in free flap monitoring in patients with oral cavity malignancy who have undergone microvascular free flap reconstruction with a visible skin paddle for post excisional defects was studied . A prospective study was conducted from November 2012 to September 2014. A standardized color card was used for the assessment of photographs. The principal investigator (P.I) was involved in taking photographs every six hours and send it to three surgeons using 3G wireless internet technology. The three surgeons: the Operating Surgeon(OPS), who was monitoring the free flaps using clinical data and photograph of the flap; the Observing Surgeon1(ObS1), who monitored using photographs only; and the Observing Surgeon 2(ObS2), who monitored using only the clinical data of the free flap. Inter-observer variability and accuracy rate of each observer in the assessment of the free flap status was used for analysis. The decision on re-exploration of the free flap was made by the operating surgeon although the input from the other two surgeons (ObS1 &ObS2) was provided to the OPS if the free flap viability was questionable. RESULTS: A total of 18 cases were analyzed from January 2013 to September 2014, with 100% free flap survival rate. Five patients were re-explored and salvaged completely. The indication for operation was neck hematoma in 4 patients and venous thrombosis in 1 patient. In the last patient, venous congestion was identified by photograph and later on clinical grounds. The accuracy rate with the use of photographs was 100%. CONCLUSION: In this study, the Smartphone photography with 3G internet technology prove to be a useful adjunct in free flap monitoring with a success rate of 100%. There was no free flap failure during the study period. The technique was useful in identifying a potential venous thrombosis which helped in decision tore explore and revise the microvascular anastomosis. The incorporation this technique in the current protocols of free flap monitoring may help identify impending flap failures even before the assessment by the senior team member.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Application of Smartphone Photography ; 3G Wireless Internet Technology ; Free Flap Monitoring ; Prospective study. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Punitha K |
| Date Deposited: | 04 May 2018 18:53 |
| Last Modified: | 04 May 2018 18:53 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/7460 |
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