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. 2023 Jun 1;56(4):344-349.
doi: 10.1055/s-0043-1769111. eCollection 2023 Aug.

Role of Lactate Measurement in Flap Monitoring: An Useful Adjunct

Karan Singh  1 , Sheerin Shah  1 , Rajinder K Mittal  1 , Ramneesh Garg  1
Affiliations

Role of Lactate Measurement in Flap Monitoring: An Useful Adjunct

Karan Singh et al. Indian J Plast Surg. .

Abstract

Background Detection of vascular compromise in flap is often a challenging task for reconstructive surgeons. A timely salvage procedure depends on objectivity and reliability of postoperative flap monitoring. This study determined if flap capillary lactate helps in prediction of flap viability in first 48 postoperative hours of surgery. Methods We conducted this study on all flaps with accessible skin paddle where capillary lactate values were assessed along with clinical observation to check viability of flap at 0, 1, 6, 12, 24 and 48 hours of surgery. The data was statistically analyzed for significance and area under the receiver operating characteristic curve was used for calculating cutoff value for lactate. Results Out of a total of 30 patients included in this study, 25 were males and the mean age was 45.03 years. Fifteen patients underwent free flap and rest pedicled. Highly significant association of role of clinical observation in the outcome of flap was found. The average of lactate values for survived and distally ischemic flap was 5.32 ± 1.91 and 8.38 ± 1.81, respectively, which was highly significant. The cutoff value of lactate below which all flaps survived was found to be 6.09 mmol/L. Conclusion Flap capillary lactate measurement is an easy, quick, cost-effective, and objective tool for checking viability of flaps.

Keywords: flap capillary lactate; flap ischemia; flap monitoring; free flaps; vascular thrombosis of flap.

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Conflict of interest statement

Conflict of Interest None declared.

Figures

Fig. 1
Fig. 1
Values of lactate measurements in survived and distally ischemic flaps.
Fig. 2
Fig. 2
Receiver operating characteristic (ROC) curve of lactate value in predicting survived and distally ischemic flaps.
Fig. 3
Fig. 3
Bar graph showing mean value of lactate in survived and distally ischemic flaps.
See this image and copyright information in PMC

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