title: Postoperative monitoring in free muscle transfers for reconstruction in brachial plexus injuries.
abstract: Free gracilis transfers are done for reanimation of the upper limb in traumatic total brachial plexus palsy. Because of buried nature of the free muscle and monitoring skin flap in the axillary or infraclavicular region, it is always a tricky situation for continuous and repeated monitoring to assess vascular status. Critical ischemia times vary between the muscle and monitoring skin flap because of which signs of ischemic changes in the monitoring skin flap are always delayed with respect to the muscle. We describe a novel method that uses the principle of evoked potentials from the muscle to assess the vascular status of the free muscle and detects vascular compromise early before the skin changes are apparent.
authors.affiliation: Department of Orthopaedics, Ogori Daiichi General Hospital, Yamaguchi, Japan.
authors.forename: Chaitanya
authors.initials: C
authors.lastname: Dodakundi
authors.forename: Kazuteru
authors.initials: K
authors.lastname: Doi
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Hattori
authors.forename: Soutetsu
authors.initials: S
authors.lastname: Sakamoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yonemura
authors.forename: Yuki
authors.initials: Y
authors.lastname: Fujihara
mesh_terms: D000200:Action Potentials; D001917:Brachial Plexus / Q000293:injuries / Q000601:surgery; D020516:Brachial Plexus Neuropathies / Q000601:surgery; D005071:Evoked Potentials; D058752:Free Tissue Flaps / Q000098:blood supply*; D006801:Humans; D008991:Monitoring, Physiologic / Q000379:methods*; D018482:Muscle, Skeletal / Q000098:blood supply* / Q000503:physiopathology / Q000637:transplantation*; D011184:Postoperative Period; D019651:Plastic Surgery Procedures