Smart Skin Flap Postsurgical Pre-warning Mobile App Design

Conference paper
Part of the Advances in Intelligent Systems and Computing book series (AISC, volume 779)


Skin flap transplantation surgery has been widely applied in repairing wound surface in clinical medicine. However, blood vessel crisis takes place easily after surgery, leading to failure of postoperative recovery. Thus, effective microcirculation observation of skin flap plays an important role in postsurgical care. For standard and convenient skin flap status monitoring and pre-warning, a smart mobile application is badly needed by both doctors and nurses. Since last August, contextual inquiry and in-depth interview of medical personnel have been conducted in the Department of Orthopedics in Xiangya Hospital Central South University, to clarify skin flap pre-warning clinical problems, requirements and application context. Feasible solution fits in clinical practice is proposed through user participated design of doctors, nurses, and technologists. UI feature list are created and UI design are prioritized by cognitive walkthrough of doctors and nurses, providing a good foundation for application development and promotion in hospital.


Skin flap postsurgical pre-warning Microcirculation observations User participatory design 



This research is partly supported by Grant No. 2017YFC0909900 from the National Key R&D Program of China and Grant No. 2017SK2013 from the Key R&D Program of Hunan Province China.


  1. 1.
    Zhang, C., Sun, J., Zhu, H., et al.: Microsurgical free flap reconstructions of the head and neck region: Shanghai experience of 34 years and 4640 flaps. Int. J. Oral Maxillofac. Surg. 44(6), 675–684 (2015)CrossRefGoogle Scholar
  2. 2.
    Whitaker, I.S., Jessop, Z.M., Grinsell, D.: Experience of 592 free tissue transfers: the case for clinical assessment alone to monitor free flaps. Eur. J. Plast. Surg. 38(2), 123–126 (2015)CrossRefGoogle Scholar
  3. 3.
    Whitaker, I.S., Rozen, W.M., Chubb, D., et al.: Postoperative monitoring of free flaps in autologous breast reconstruction: a multicenter comparison of 398 flaps using clinical monitoring, microdialysis, and the implantable Doppler probe. J. Reconstr. Microsurg. 26(6), 409–416 (2010)CrossRefGoogle Scholar
  4. 4.
    Cervenka, B., Bewley, A.F.: Free flap monitoring: a review of the recent literature. J. Curr. Opin. Otolaryngol. Head Neck Surg. 23(5), 393–398 (2015)CrossRefGoogle Scholar
  5. 5.
    Creech, B.J.M.S., Miller, S.: Evaluation of Circulation in Skin Flaps. Skin Flaps, vol. 21. Little, Brown, Boston (1975)Google Scholar
  6. 6.
    Jallali, N., Ridha, H., Butler, P.E.: Postoperative monitoring of free flaps in UK plastic surgery units. J. Microsurg. 25(6), 469–472 (2005)CrossRefGoogle Scholar
  7. 7.
    Pratt, G.F., et al.: Modern adjuncts and technologies in microsurgery: an historical and evidence-based review. J. Microsurg. 30(8), 657–666 (2010)CrossRefGoogle Scholar
  8. 8.
    Whitaker, I.S., et al.: Variations in the postoperative management of free tissue transfers to the head and neck in the United Kingdom. Br. J. Oral Maxillofac. Surg. 45(1), 16–18 (2007)CrossRefGoogle Scholar
  9. 9.
    Luu, Q., Farwell, D.G.: Advances in free flap monitoring: have we gone too far? J. Curr. Opin. Otolaryngol. Head Neck Surg. 17(4), 267–269 (2009)CrossRefGoogle Scholar
  10. 10.
    Engel, H., et al.: Remote real-time monitoring of free flaps via smartphone photography and 3G wireless internet: a prospective study evidencing diagnostic accuracy. J. Microsurg. 31(8), 589–595 (2011)CrossRefGoogle Scholar
  11. 11.
    Kiranantawat, K., et al.: The first smartphone application for microsurgery monitoring: SilpaRamanitor. J. Plast. Reconstr. Surg. 134(1), 130–139 (2014)CrossRefGoogle Scholar
  12. 12.
    Spinuzzi, C.: The methodology of participatory design. J. Tech. Commun. 52(2), 163–174 (2005)Google Scholar
  13. 13.
    Schuler, D., Namioka, A. (eds.): Participatory Design: Principles and Practices. CRC Press, Boca Raton (1993)Google Scholar
  14. 14.
    Asaro, P.M.: Transforming society by transforming technology: the science and politics of participatory design. J. Acc. Manag. Inf. Technol. 10(4), 257–290 (2000)Google Scholar
  15. 15.
    Falcão, T.P., et al.: Participatory methodologies to promote student engagement in the development of educational digital games. J. Comput. Educ. 116, 161–175 (2018)CrossRefGoogle Scholar
  16. 16.
    Kreidstein, M.L., Levine, R.H., Knowlton, R.J., Pang, C.Y.: Serial fluorometric assessments of skin perfusion in isolated perfused human skin flaps. Br. J. Plast. Surg. 48, 288–293 (1995)CrossRefGoogle Scholar
  17. 17.
    Haddock, N.T., Gobble, R.M., Levine, J.P.: More consistent postoperative care and monitoring can reduce costs following microvascular free flap reconstruction. J. Reconstr. Microsurg. 26(07), 435–439 (2010)CrossRefGoogle Scholar
  18. 18.
    Smit, J.M., et al.: Advancements in free flap monitoring in the last decade: a critical review. J. Plast. Reconstr. Surg. 125(1), 177–185 (2010)CrossRefGoogle Scholar
  19. 19.
    Salgado, C.J., Moran, S.L., Mardini, S.: Flap monitoring and patient management. J Plast. Reconstr. Surg. 124(6S), 295–302 (2009)CrossRefGoogle Scholar
  20. 20.
    Hentz, V.R., Mathes, S.J.: Plastic Surgery. Saunders, Philadelphia (2005)Google Scholar
  21. 21.
    Chunlin, H.: Skin Flap Surgery. Shanghai Science and Technology Publisher, Shanghai (2013)Google Scholar
  22. 22.
    Martin, H.A., Ciurzynski, S.M.: Situation, background, assessment, and recommendation - Guided huddles improve communication and teamwork in the emergency department. J. Emerg. Nurs. 41(6), 484–488 (2015)CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Mobile Health Ministry of Education-China Mobile Joint LaboratoryXiangya Hospital Central South UniversityChangshaPeople’s Republic of China
  2. 2.University of SunderlandSunderlandUK

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