Abstract Aims To evaluate a novel infrared (IR) spectroscopy device with an integrated predictive algorithm for continuous monitoring of free flaps, aiming to reduce flap failure rates and associated healthcare costs. Methods We designed a device comprising two disposable IR sensors placed above and below the site of vascular anastomosis, connected to a standalone monitor. The sensors provide continuous readings of flap oxygen saturation. An in-built algorithm detects early deviations in perfusion and triggers alerts for clinical review. A business model and regulatory pathway were developed to enable clinical implementation. Results NHS data from 2019–2020 reported 25 834 flap procedures, with failure rates of 8.6–14%. Current monitoring protocols are intermittent, subjective, and resource-intensive. Literature suggests IR monitoring improves flap salvage rates by up to 39%. Our device offers objective, real-time monitoring and automated alerts, reducing observer variability. Projected economic modelling demonstrated reduced reoperation costs (£3360) and shortened inpatient stay (£900–4200), with substantial overall cost savings per patient. Discussion This device addresses limitations of current flap monitoring by providing continuous, sensitive, and objective data, facilitating earlier intervention and higher flap salvage rates. Its scalability, compatibility with NHS practice, and lower consumable costs compared to current competitors (for example ViOptix) position it as a feasible and cost-effective alternative. Future directions include algorithm refinement, multicentre trials, and integration with electronic patient records to optimise personalised surgical care.
Chen et al. (Sun,) studied this question.