How we do it: Postoperative tissue oxygen monitoring in microvascular free flaps

Keypoints • Postoperative circulatory impairment of free microvascular flaps leads to failure of the reconstructions and major re‐operations. • In the head and neck region vitality of the reconstructed site is often difficult to observe especially in flaps placed in the posterior oral cavity or hypopharynx. • The ideal follow‐up method should be easy to use, reliable, harmless to the flap and it should rapidly alert the personnel to circulatory problems. • Thirty‐seven head and neck tumour patients who underwent a major tumour resection and free microvascular flaps reconstruction were monitored with a Licox® probe measuring tissue oxygen pressure (PtiO2). • The system correctly identified all circulatory problems that needed re‐operations with no false negative cases. • The Licox® tissue oxygen pressure monitoring system is a reliable method for detecting postoperative circulation problems in free microvascular flaps.