# Evaluation of Flap Survival Using Local Glucose Measurement in Dogs Undergoing Reconstructive Procedures: Two Case Reports

## TL;DR

This paper explores using local glucose measurements to monitor blood flow in reconstructive skin flaps in dogs, showing it can detect issues earlier than visual checks.

## Contribution

The study introduces local glucose monitoring as a novel, minimally invasive tool for assessing flap viability in veterinary reconstructive surgery.

## Key findings

- Local glucose levels in a dog with normal healing briefly declined before returning to normal.
- A dog with flap necrosis had persistently low glucose levels, indicating impaired blood flow.
- Glucose monitoring detected vascular compromise earlier than visual inspection in one case.

## Abstract

Successful healing of reconstructive skin flaps depends on maintaining adequate blood supply. In veterinary practice, evaluating flap viability often relies on subjective observations such as skin color or temperature, which may not detect early circulatory problems. In human reconstructive surgery, measuring local glucose levels has become an objective and minimally invasive method for identifying early signs of compromised blood flow. This report describes two dogs that underwent reconstructive surgery in which local glucose levels were measured postoperatively using a handheld glucometer. In the dog with normal healing, glucose values showed only a brief decline before returning to normal. In contrast, the dog that developed flap necrosis had persistently low glucose values throughout the monitoring period. These findings suggest that local glucose measurement may help veterinarians detect impaired flap circulation earlier than visual inspection alone, potentially improving treatment decisions and patient outcomes.

Early recognition of vascular compromise is essential for reconstructive flap survival. In human surgery, local glucose monitoring is widely used as an objective indicator of perfusion, but its application in veterinary patients is still limited. This report describes postoperative glucose measurement as a simple and minimally invasive method for evaluating flap viability in two dogs. This report describes two prospectively observed clinical cases in which local glucose measurement was applied as an adjunctive monitoring tool during postoperative flap management. Local glucose values were measured with a handheld glucometer at predefined flap and control sites. Serial readings were compared with daily assessments of flap color, temperature, turgor, and wound integrity. A previously suggested threshold of 60–62 mg/dL was used as a reference for potential perfusion compromise. In Case 1, a phalangeal fillet flap showed a brief glucose decline on postoperative days 2–3, followed by normalization and uneventful healing. In Case 2, which underwent advancement flap reconstruction after wound dehiscence, glucose values remained persistently below 60 mg/dL and preceded visible ischemia and distal necrosis. Local glucose monitoring provided rapid and clinically meaningful information about flap perfusion. Transient decreases reflected reversible postoperative congestion, whereas persistent hypoglycemia indicated progressive ischemia. These findings support the use of glucose monitoring as an adjunct in small-animal reconstructive surgery.