Background: Licox® PtO2 is a minimally invasive monitoring system for continuous measurement
of tissue oxygen tension in all types of free tissue transfers. Our study compares two consecutive
series of patients undergoing microsurgical reconstruction monitored with standard
clinical bedside surveillance and with the Licox® PtO2 system regarding flap loss and flap salvage,
the sensitivity, specificity, and cost-effectiveness.
Methods: We performed a longitudinal observational prospective study of all patients undergoing
microsurgical reconstructions between 2016 and 2017. Group 1 included 43 patients that
underwent standard clinical bedside postoperative flap monitoring whereas group 2 included
44 consecutive patients also monitored with Licox® PtO2 system. Flap complications such as
return to theater for vascular compromise, partial and total flap loss and flap salvage rate were
analyzed.
Results: We recorded no significant difference between the two groups regarding the rate of
vascular complications (P = .31), return to the theater (P = .31), flap salvage (P = .9), partial and
total flap loss (P = .36 and P = .49, respectively). When analyzing the Licox® PtO2 system monitoring
group, we documented six false-positive results (13.6%) and 0 false negatives with an
accuracy of 0.86, a sensibility of 1.00, and a specificity of 0.85.
Conclusions: This is the first study that provides statistical data about the comparison of postoperative
free flap monitoring by standard clinical bedside method and Licox® PtO2 system. For
the monitoring of buried flaps, the Licox® PtO2 monitoring can be used only as a supplement to
other systems. Its use, compared to near-infrared spectroscopy or clinical bedside monitoring,
was not found cost-efficient.
