Significance of vesicles in flap monitoring in oral cancer surgery: Report of two cases

The success rate of vascularized free flap transplantation in head and neck oncologic surgery is high, ranging from 94% to 98.8%; however, flap necrosis sometimes occurs after surgery. When vessel-related complications occur, flap necrosis proceeds rapidly. Thus, flap monitoring after surgery is especially important. We recently treated two patients with flap-related complications. A vesicle appeared on the surface of the flap and enlarged within a short time; the flap’s color changed to purple, and a reoperation was eventually performed. While there are approaches to monitor flaps, this is the first report suggesting the assessment of vesicle formation for flap monitoring, since the vesicles occur several hours before changes in the flap color.