Innovations that allow us to accurately assess flap perfusion can improve patient outcomes and contribute to the advancement of reconstructive microsurgery. Traditionally, flap perfusion has been assessed clinically by examining the tissue for its colour, temperature, capillary refill time, turgor, ability to bleed, presence of doppler signals and oxygen saturation levels. However, the clinical assessment of a flap is not always a sensitive measure and in many cases the findings may be ambiguous. In our experience these would include cases where skin colour is either very pale or very dark, and in adipofascial or bone flaps where there is no skin paddle.

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