{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T09:19:25Z","timestamp":1770887965825,"version":"3.50.1"},"reference-count":28,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Handchir Mikrochir Plast Chir"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n                    Hintergrund Freie Muskellappenplastiken zur Rekonstruktion gro\u00dfer Weichteildefekte sind neben fasziokutanen Lappenplastiken etablierte mikrochirurgische Standardverfahren. Diese werden h\u00e4ufig mit adipokutanen Monitorinseln zur Durchblutungskontrolle geplant. In unserer Klinik werden sowohl konventionelle, breitbasig aufsitzende adipokutane Monitorinseln (random pattern), als auch perforatorbasierte Monitorinseln verwendet. W\u00e4hrend konventionelle Monitorinseln in einer zweiten Operation abgetragen werden m\u00fcssen und der verbliebene Defekt mit Spalthauttransplantaten versorgt werden muss, k\u00f6nnen perforatorbasierte Monitorinseln am Patientenbett mittels einfacher Ligatur entfernt werden. In der vorliegenden Studie sollen \u00f6konomische, versorgungsqualitative und \u00e4sthetische Aspekte perforatorbasierter versus herk\u00f6mmlicher adipokutaner Monitorinseln nach freiem Muskellappentransfer verglichen werden.<\/jats:p><jats:p>\n                    Patienten und Methoden Im Zeitraum von August 2014 bis Juli 2016 konnten anhand einer retrospektiven Datenanalyse 102 geeignete Patienten identifiziert werden. Patienten mit perforatorbasierter Monitorinsel (Gruppe A) wurden einem Kollektiv von Patienten mit breitbasig aufsitzender Monitorinsel (Gruppe B) gegen\u00fcbergestellt. Patientencharakteristika, Operationszeiten, \u00f6konomische Daten und \u00e4sthetische Ergebnisse wurden zwischen den Gruppen verglichen.<\/jats:p><jats:p>\n                    Ergebnisse Bei 72\u2005Patienten wurden perforatorbasierte (Gruppe A, 71\u2005%), bei 30\u2005Patienten konventionelle (Gruppe B, 29\u2005%) Monitorinseln gehoben. Patienten-, Defekt- und Lappencharakteristika waren in beiden Gruppen vergleichbar. Operations- und S\u00e4ulenzeit waren in Gruppe B tendenziell k\u00fcrzer, jedoch ohne statistische Signifikanz zu erreichen (p\u2005=\u20050,35; p\u2005=\u20050,28). Die Entfernung der Monitorinsel in Gruppe A erfolgte signifikant fr\u00fcher (p\u2005&lt;\u20050,01). Sowohl die gesamtstation\u00e4re als auch die postrekonstruktive Verweildauer waren in Gruppe A signifikant k\u00fcrzer (p\u2005=\u20050,03; p\u2005&lt;\u20050,01). Personelle und materielle Ressourcen konnten in Gruppe A geschont und ein \u00e4sthetisch ansprechenderes Ergebnis erzielt werden.<\/jats:p><jats:p>\n                    Schlussfolgerung Mit perforatorbasierten Monitorinseln kann eine zweite Operation zur Monitorinselabtragung und Hauttransplantation vermieden werden. Hierdurch kann eine Reduktion der station\u00e4ren Verweildauern mit Schonung der materiellen und personellen Ressourcen erreicht werden.<\/jats:p>","DOI":"10.1055\/a-1655-9135","type":"journal-article","created":{"date-parts":[[2022,3,14]],"date-time":"2022-03-14T23:59:30Z","timestamp":1647302370000},"page":"139-148","source":"Crossref","is-referenced-by-count":3,"title":["Postoperatives Monitoring freier Muskellappenplastiken mittels perforatorbasierten adipokutanen Monitorinseln: \u00d6konomie, Versorgungsqualit\u00e4t und \u00c4sthetik"],"prefix":"10.1055","volume":"54","author":[{"given":"Sarah Sopie","family":"Nagel","sequence":"additional","affiliation":[{"name":"BG Unfallklinik Ludwigshafen Klinik f\u00fcr Hand-, Plastische und Rekonstruktive Chirurgie, Mikrochirurgie, Schwerbrandverletztenzentrum, Plastische Chirurgie und Handchirurgie der Universit\u00e4t Heidelberg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Thomas","sequence":"additional","affiliation":[{"name":"BG Unfallklinik Ludwigshafen Klinik f\u00fcr Hand-, Plastische und Rekonstruktive Chirurgie, Mikrochirurgie, Schwerbrandverletztenzentrum, Plastische Chirurgie und Handchirurgie der Universit\u00e4t Heidelberg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amir K.","family":"Bigdeli","sequence":"additional","affiliation":[{"name":"BG Unfallklinik Ludwigshafen Klinik f\u00fcr Hand-, Plastische und Rekonstruktive Chirurgie, Mikrochirurgie, Schwerbrandverletztenzentrum, Plastische Chirurgie und Handchirurgie der Universit\u00e4t Heidelberg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Hirche","sequence":"additional","affiliation":[{"name":"BG Unfallklinik Frankfurt am Main Abteilung f\u00fcr Plastische, Hand- und Rekonstruktion Mikrochirurgie, Handtrauma- und Replantationszentrum"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrich","family":"Kneser","sequence":"additional","affiliation":[{"name":"BG Unfallklinik Ludwigshafen Klinik f\u00fcr Hand-, Plastische und Rekonstruktive Chirurgie, Mikrochirurgie, Schwerbrandverletztenzentrum, Plastische Chirurgie und Handchirurgie der Universit\u00e4t Heidelberg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1995-2944","authenticated-orcid":false,"given":"Christian Andreas","family":"Radu","sequence":"additional","affiliation":[{"name":"BG Unfallklinik Ludwigshafen Klinik f\u00fcr Hand-, Plastische und Rekonstruktive Chirurgie, Mikrochirurgie, Schwerbrandverletztenzentrum, Plastische Chirurgie und Handchirurgie der Universit\u00e4t 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surgery"},{"issue":"11","key":"ref4","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1002\/micr.1920161103","article-title":"Free flap monitoring: a review of current practice","volume":"16","author":"M B Hirigoyen","year":"1995","journal-title":"Microsurgery"},{"issue":"01","key":"ref5","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1055\/s-0039-1677880","article-title":"Postoperative Free-Flap Monitoring Techniques","volume":"33","author":"S Kohlert","year":"2019","journal-title":"Semin Plast Surg"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1055\/s-2007-1006843","article-title":"A contrivance for monitoring skin flaps with a Doppler flowmeter","volume":"6","author":"K Tsuzuki","year":"1990","journal-title":"J Reconstr Microsurg"},{"issue":"02","key":"ref7","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1097\/00006534-199108000-00020","article-title":"Impedance plethysmography: a new method for continuous muscle perfusion monitoring","volume":"88","author":"M J Concannon","year":"1991","journal-title":"Plastic and reconstructive surgery"},{"issue":"02","key":"ref8","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/S0363-5023(85)80109-X","article-title":"Serial quantitative skin surface fluorescence: a new method for postoperative monitoring of vascular perfusion in revascularized digits","volume":"10","author":"B H Graham","year":"1985","journal-title":"The Journal of hand surgery"},{"issue":"05","key":"ref9","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1016\/S0363-5023(86)80013-2","article-title":"Pulse oximetry for vascular monitoring in upper extremity replantation surgery","volume":"11","author":"B Graham","year":"1986","journal-title":"The Journal of hand surgery"},{"issue":"04","key":"ref10","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1055\/s-2007-1006996","article-title":"Routine clinical use of laser Doppler flowmeter to monitor free tissue transfer: preliminary results","volume":"3","author":"S D Jenkins","year":"1987","journal-title":"J Reconstr Microsurg"},{"issue":"01","key":"ref11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1055\/s-2007-1007039","article-title":"The value of the photoplethysmograph in monitoring skin closure in microsurgery","volume":"2","author":"L R Scheker","year":"1985","journal-title":"J Reconstr Microsurg"},{"issue":"02","key":"ref12","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1002\/micr.1920050212","article-title":"A microminiature photoplethysmograph probe for microvascular surgery","volume":"5","author":"D J Doyle","year":"1984","journal-title":"Microsurgery"},{"issue":"01","key":"ref13","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1055\/s-2007-1006758","article-title":"Liquid crystal temperature monitoring for microsurgery","volume":"7","author":"L A Sudarsky","year":"1991","journal-title":"J Reconstr Microsurg"},{"issue":"04","key":"ref14","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1097\/00000637-198310000-00013","article-title":"Tissue pH monitoring in microsurgery: a preliminary evaluation of continuous tissue pH monitoring as an indicator of perfusion disturbances in microvascular free flaps","volume":"11","author":"D J Raskin","year":"1983","journal-title":"Ann Plast Surg"},{"issue":"03","key":"ref15","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1002\/micr.1920020303","article-title":"Transcutaneous PO2 monitoring for assessing viability and predicting survival of skin flaps: experimental and clinical correlations","volume":"2","author":"D Serafin","year":"1981","journal-title":"J Microsurg"},{"issue":"02","key":"ref16","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/S0363-5023(83)80004-5","article-title":"Clinical application of transcutaneous oxygen measurements in replantation surgery and free tissue transfer","volume":"8","author":"A R Smith","year":"1983","journal-title":"The Journal of hand surgery"},{"issue":"03","key":"ref17","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1016\/0007-1226(86)90047-0","article-title":"The muscle twitch monitor: a rapid unequivocal method of monitoring free muscle transfers","volume":"39","author":"P M Davison","year":"1986","journal-title":"Br J Plast Surg"},{"issue":"03","key":"ref18","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1097\/00000637-199909000-00027","article-title":"Technetium 99\u2005m sestamibi scintigraphy for noninvasive assessment of muscle flap viability","volume":"43","author":"A C Aygit","year":"1999","journal-title":"Ann Plast Surg"},{"issue":"03","key":"ref19","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1055\/s-0037-1608628","article-title":"Evaluation of the Implantable Doppler Probe for Free Flap Monitoring in Lower Limb Reconstruction","volume":"34","author":"Y Lenz","year":"2018","journal-title":"J Reconstr Microsurg"},{"issue":"03","key":"ref20","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1097\/00000637-198703000-00006","article-title":"Clinical evaluation of laser Doppler blood flow measurements in free flaps","volume":"18","author":"M Walkinshaw","year":"1987","journal-title":"Ann Plast Surg"},{"issue":"05","key":"ref21","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1097\/MOO.0000000000000189","article-title":"Free flap monitoring: a review of the recent literature","volume":"23","author":"B Cervenka","year":"2015","journal-title":"Curr Opin Otolaryngol Head Neck Surg"},{"issue":"12","key":"ref22","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1111\/ans.13522","article-title":"Free-flap salvage: muscle only versus skin paddle \u2013 an Australian experience","volume":"87","author":"A D Dat","year":"2017","journal-title":"ANZ journal of surgery"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"2399","DOI":"10.1002\/hed.25347","article-title":"Effectiveness of small monitoring skin paddle in free muscle flap for scalp reconstruction","volume":"40","author":"S O Park","year":"2018","journal-title":"Head Neck"},{"issue":"03","key":"ref24","doi-asserted-by":"crossref","first-page":"586e","DOI":"10.1097\/PRS.0b013e3182419c54","article-title":"Perforator-based monitoring skin islands in free muscle flaps: teaching old dogs new tricks","volume":"129","author":"J P Beier","year":"2012","journal-title":"Plastic and reconstructive surgery"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1016\/j.bjps.2020.10.016","article-title":"Random-pattern versus perforator-based adipocutaneous skin paddles for postoperative monitoring of free muscle flaps-a comparative retrospective cohort study","volume":"74","author":"S S Nagel","year":"2020","journal-title":"J Plast Reconstr Aesthet 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Chirurgie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1655-9135.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T04:22:51Z","timestamp":1649910171000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1655-9135"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,14]]},"references-count":28,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2022,4,13]]},"published-print":{"date-parts":[[2022,4]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1655-9135","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0722-1819","1439-3980"],"issn-type":[{"value":"0722-1819","type":"print"},{"value":"1439-3980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,14]]}}}