Clinical Application of Dynamic Skin Temperature Monitor Combined With Structured Nursing Handover in Postoperative Flap Monitoring

Objective: To evaluate the clinical application of a dynamic skin temperature monitor combined with structured nursing handover in postoperative skin flap monitoring and to assess its impact on the early identification of vascular crisis and flap prognosis. Methods: A retrospective analysis was performed on 46 patients undergoing free flap transplantation in the Department of Orthopedics of a tertiary class A hospital between July 2025 and May 2026. Patients assigned to the preprotocol group (July 2025 to December 2025, n=29) received routine clinical monitoring and traditional verbal nursing handover. For the postprotocol group (January 2026 to May 2026, n=17), continuous skin temperature monitoring with a dynamic skin temperature monitor was implemented, alongside a structured nursing handover process based on the Microsurgery Skin Flap Postoperative Registration Form and an immediate notification mechanism for abnormal data. The primary outcomes included vascular crisis incidence and flap survival rate, while secondary outcomes covered the time from abnormality detection to intervention, handover completeness score, and nurse satisfaction. Results: Among the 46 patients undergoing free flap transplantation, the overall vascular crisis incidence was 17.4% (8/46). The postprotocol group had a lower vascular crisis rate compared with the preprotocol group (11.8% vs. 20.7%, P =0.441). Time from abnormality to detection was significantly shorter in the postprotocol group (15.5±4.9 min vs. 52.3±20.0 min, P =0.002), as was time from detection to intervention (22.0±9.9 min vs. 39.2±8.0 min, P =0.018). Handover completeness scores improved from 70.7±9.4% to 92.2±4.2% ( P <0.001), and information omission items decreased from 3.1±1.3 to 0.3±0.7 ( P <0.001). The AUC for temperature monitoring in diagnosing vascular crisis was 0.92 (95% CI: 0.86-0.98). Conclusion: The combination of dynamic skin temperature monitoring and structured nursing handover was associated with earlier identification of vascular crisis, shorter detection-to-intervention intervals, and improved nursing handover quality in patients undergoing flap surgery. These findings suggest that the integrated protocol may be associated with improved postoperative outcomes. However, the retrospective before-and-after design cannot eliminate the interference of temporal trends and other secular confounding factors, which precludes definitive causal inference.