title: Comparison of Video and In-person Free Flap Assessment following Head and Neck Free Tissue Transfer.
abstract: Objective Compare the efficiency of remote telehealth flap assessments with traditional in-person flap assessments. Study Design Observational study with retrospective review. Setting Tertiary academic medical center. Subjects and Methods All patients undergoing head and neck free tissue transfer were included in the study. All patients whose surgery was performed at hospital A underwent an in-person flap check overnight. Those at hospital B received a remote flap assessment. The primary outcome was total time spent performing the midnight flap assessment, including travel time. Data were gathered prospectively using an online survey. Results Sixty consecutive patients met inclusion criteria. On the night of the surgery, 31 had an in-person flap check while 29 had a video telehealth flap check. There were no partial or total flap losses or take-backs resulting from the flap checks. Mean (SD) times for in-person and remote assessments were 34 (16) minutes (range, 10-60 minutes) and 13 (8) minutes (range, 5-35 minutes), respectively ( P < .001). House staff unanimously felt the remote telehealth system improved their quality of life without affecting their perception of the quality of the flap assessment ( P = .001). Conclusion Compared with in-person flap assessments in this cohort, telehealth assessments allowed more efficient examination of free tissue reconstructions while yielding seemingly equivalent information. Therefore, remote telehealth flap checks may provide useful information supporting the use of high-fidelity remote data-streaming technology in the delivery of complex care to patients distant from their care provider.
authors.affiliation: 1 Department of Otolaryngology, Head & Neck Surgery, University of California San Francisco, San Francisco, California, USA.
authors.forename: A Sean
authors.initials: AS
authors.lastname: Alemi
authors.affiliation: 1 Department of Otolaryngology, Head & Neck Surgery, University of California San Francisco, San Francisco, California, USA.
authors.forename: Rahul
authors.initials: R
authors.lastname: Seth
authors.affiliation: 1 Department of Otolaryngology, Head & Neck Surgery, University of California San Francisco, San Francisco, California, USA.
authors.forename: Chase
authors.initials: C
authors.lastname: Heaton
authors.affiliation: 1 Department of Otolaryngology, Head & Neck Surgery, University of California San Francisco, San Francisco, California, USA.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Wang
authors.affiliation: 1 Department of Otolaryngology, Head & Neck Surgery, University of California San Francisco, San Francisco, California, USA.
authors.forename: P Daniel
authors.initials: PD
authors.lastname: Knott
mesh_terms: D005260:Female; D058752:Free Tissue Flaps; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011183:Postoperative Complications / Q000175:diagnosis*; D011788:Quality of Life; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D017216:Telemedicine; D014741:Video Recording
keywords: free flap failure; free flap monitoring; resident duty hours; telehealth; telemedicine; video conference