Abstract
Conventional skin flap monitoring is one of the widely used methods to assess postoperative
circulation in innervated free muscle transfer (IFMT). However, following reexploration
for vascular compromise and reestablishing circulation, functional recovery of the
muscle despite surviving skin flap is not clear. The purpose of this article is to
report three such cases and determine the reliability of viable skin flap in an IFMT
with a second ischemic event. Long-term functional results were assessed in terms
of reinnervation time, elbow range of motion, strength of elbow flexion, finger function
in terms of total active motion, and power lifting with hook grip. These IFMTs developed
complete or partial necrosis of the muscle and could not obtain satisfactory function.
The conventional monitoring of the skin flap did not promptly reflect vascularity
of IFMT, and a surviving skin flap after reexploration for compromised vascularity
does not guarantee complete survival of the muscle. There is a need for earlier and
rapid detection of vascular compromise in IFMTs.
Keywords
free muscle transfer - vascular compromise - reexploration
