3 Since 2009, the ViOptix device offers built-in Wi-Fi, allowing its continuous oximetry recording to be sent to the provider’s SD. As for continuous monitoring using objective parameter, there is 1 report qualifying the wireless capability of the ViOptix device. Remote methodologies of free-flap monitoring have not been widely published. These Internet-based SD apps are employed in conjunction with the laser Doppler flowmeter (LDF) for routine adjunctive monitoring of free flaps. The second modality uses the app (LogMeIn, Boston, Mass.), which allows the computer desktop to be shared as a teleconference host, while the app on another SD allows the surgeon to join the meeting and view remotely any data displayed in real-time on the bedside computer. One modality uses the AtHome app (iChano, inc, Richmond, BC, Canada), which converts an SD into a wireless video camera, while its viewer app on a remote SD receives the continuous streaming via Wi-Fi or mobile broadband (3G, 4G, LTE network). This article presents the currently available techniques in remote free-flap monitoring and describes 2 new modalities using adaptation of free applications (apps) on smart devices (SD). The 2 methodologies reported here provided reliable continuous transmission of quantitative data of flap perfusion to smart devices via Internet connection, which can revolutionize the microsurgeon's practice if his/her adjunctive perfusion monitor with display does not yet have Wi-Fi capability.Īlthough the use of telemedicine has become widespread, little has been published describing real-time remote monitoring of free-flap perfusion. Literature review identified very few articles describing remote monitoring of free flaps. Minor mechanical issues were encountered with the video streaming method. The Internet connectivity became disrupted only on several occasions, requiring simple Wi-Fi and software reset. All free flaps were monitored remotely for 4–6 days with near 100% reliability. These 2 methodologies were employed on 9 and 8 free flaps, respectively, as a pilot study. A live feed of the computer's desktop as a teleconference host is transmitted to the surgeon's smart device over the Internet. In addition, 2 wireless methodologies are devised: One method uses a free app that converts a smart device into a camera, stationed next to the perfusion monitor, to stream live video of the laser Doppler readout to the surgeon's smartphone a second method uses a free app installed on a bedside laptop computer, which is connected to the laser Doppler flowmeter via a data cord. A literature review was conducted to identify reports relating to remote free flap monitoring. Two simple adaptations using free apps (applications) and smart devices can enable transmission of the perfusion readout to the surgeon's smartphone. Remote monitoring capability does not currently exist for Periflux (Perimed AB, Järfälla, Sweden) laser Doppler and other perfusion monitors.
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