Transcutaneous oxygen measurement using ratiometric fluorescence imaging as a valid method for monitoring free flap transplants.
Postoperative free flap monitoring
flap monitoring
flux imaging
microcirculatory function
tissue oxygenation
tissue perfusion
transcutaneous oxygen measurement
Journal
Clinical hemorheology and microcirculation
ISSN: 1875-8622
Titre abrégé: Clin Hemorheol Microcirc
Pays: Netherlands
ID NLM: 9709206
Informations de publication
Date de publication:
2019
2019
Historique:
pubmed:
29
9
2019
medline:
8
2
2020
entrez:
29
9
2019
Statut:
ppublish
Résumé
Reconstruction of soft tissue defects with free flaps is a common procedure in plastic and reconstructive surgery. Most postoperative complications occur within the first 48-72 hours after surgery. After postoperative complications, short perfusion restoration times may improve flap survival rates by up to 30-50%. Ratiometric fluorescence imaging is an additional or alternative method of postoperative flap monitoring. To test the efficacy and utility of transepidermal oxygen flux imaging to evaluate postoperative skin oxygenation of free and local flaps in the first 48 hours after surgery. The study included 32 patients (aged between 18 and 80 years; mean age 52.9) with a tissue defect covered with a free flap transplant at the Department of Plastic and Reconstructive Surgery of the University Medical Center Regensburg. Postoperative oxygen flux was measured with the 'VisiSens system' placed on the vascular pedicle as well as on the peripheral and central part of the flap. Values of oxygen flux were higher in case of flap congestion (0.069±0.012) or flap necrosis (0.155±0.083) than in cases without any complications (0.061±0.006). Flux values of different areas of the same flap showed only minimal differences (central part: 0.065±0.008, peripheral part: 0.070±0.009, vascular pedicle: 0.056±0.004); the level of significance was p = 0.904. Imaging transepidermal oxygen flux by ratiometric luminescence seems to be a reliable alternative, indirect method of postoperative flap monitoring with regard to microcirculatory function and flap viability.
Sections du résumé
BACKGROUND
BACKGROUND
Reconstruction of soft tissue defects with free flaps is a common procedure in plastic and reconstructive surgery. Most postoperative complications occur within the first 48-72 hours after surgery. After postoperative complications, short perfusion restoration times may improve flap survival rates by up to 30-50%. Ratiometric fluorescence imaging is an additional or alternative method of postoperative flap monitoring.
OBJECTIVE
OBJECTIVE
To test the efficacy and utility of transepidermal oxygen flux imaging to evaluate postoperative skin oxygenation of free and local flaps in the first 48 hours after surgery.
METHODS
METHODS
The study included 32 patients (aged between 18 and 80 years; mean age 52.9) with a tissue defect covered with a free flap transplant at the Department of Plastic and Reconstructive Surgery of the University Medical Center Regensburg. Postoperative oxygen flux was measured with the 'VisiSens system' placed on the vascular pedicle as well as on the peripheral and central part of the flap.
RESULTS
RESULTS
Values of oxygen flux were higher in case of flap congestion (0.069±0.012) or flap necrosis (0.155±0.083) than in cases without any complications (0.061±0.006). Flux values of different areas of the same flap showed only minimal differences (central part: 0.065±0.008, peripheral part: 0.070±0.009, vascular pedicle: 0.056±0.004); the level of significance was p = 0.904.
CONCLUSION
CONCLUSIONS
Imaging transepidermal oxygen flux by ratiometric luminescence seems to be a reliable alternative, indirect method of postoperative flap monitoring with regard to microcirculatory function and flap viability.
Identifiants
pubmed: 31561353
pii: CH199225
doi: 10.3233/CH-199225
doi:
Substances chimiques
Oxygen
S88TT14065
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM