Non-invasive monitoring of the state of free vascularized graft in microsurgery of the musculoskeletal system

Control of blood circulation of a free vascularized graft is the most important problem in microsurgery of the musculoskeletal system in adults and children. In such transplants, ischemic and reperfusion changes in the microvasculature and cellular elements of tissues occur. The progression of these disorders, for example, due to insufficient anastomoses, can lead to partial necrosis, and in some cases to complete death of the graft, negating the results of a complex, many-hour operation. The failure rate after microvascular autotransplantation is 5–10%, more than half of which are pedicle thrombosis [32]. The development of optimal methods of postoperative monitoring can provide timely correction and prevention of irreversible tissue ischemia, and improve treatment results