Clinical application of transcutaneous oxygen measurements in replantation surgery and free tissue transfer.

In 65 replantations and 18 free tissue transfers (6 toe-to-thumb and 12 free flaps) transcutaneous oxygen levels were used as a postoperative monitoring system of the microcirculation. In successful replants and successful free tissue transfers an identical pattern of oxygen levels was observed. In failing replants or free tissue transfer, PO2 levels react immediately to changes in microcirculation and these changes in PO2 appear several hours earlier than the clinical symptoms or changes in temperature. This enables salvage operations after circulatory failure caused by thrombosis to be performed before irreversible tissue damage occurs.