This prospective study was designed to compare the accuracy rate between remote smartphone photographic assessments and in-person examinations for free flap monitoring. One hundred and three consecutive free flaps were monitored with in-person examinations and assessed remotely by three surgeons (Team A) via photographs transmitted over smartphone. Four other surgeons used the traditional in-person examinations as Team B. The response time to re-exploration was defined as the interval between when a flap was evaluated as compromised by the nurse/house officer and when the decision was made for re-exploration. The accuracy rate was 98.7% and 94.2% for in-person and smartphone photographic assessments, respectively. The response time of 8 ± 3 min in Team A was statistically shorter than the 180 ± 104 min in Team B (P = 0.01 by the Mann-Whitney test). The remote smartphone photography assessment has a comparable accuracy rate and shorter response time compared with in-person examination for free flap monitoring.

Infantile hemangioma is a common vascular tumor of infants. Kasabach-Merritt syndrome (KMS) is a rear but dangerous type of hemangioma. The present study analyzed the therapeutic and side effects of local administration of urea combined with methylprednisolone for the treatment of KMS in the maxillofacial region of infants. A retrospective study was conducted on the KMS patients in the department from July 2012 to September 2020. A total of 14 cases of KMS in infants’ maxillofacial region were treated with local injection of 40% urea solution and methylprednisone after the external carotid artery ligation. After 6–36 months of follow-up, 13 out of 14 cases were cured and 1 case was improved. During treatment, 2 cases relapsed and were treated continuously with local injection of urea for 6–10 more days. High efficacy and satisfactory recovery were observed in all cases after 1–2 months of treatment. No death or serious side effect occurred in the 14 cases. External carotid artery catheterization with urea and methylprednisolone injection is effective for the treatment of maxillofacial Kasabach-Merritt syndrome in infants. Careful postoperative observation and management of tube placement are important for the success of catheterization treatment.