Flap perfusion monitoring with an attached surface probe in microvascular reconstruction of the oral cavity.
Attached surface probe
Flap perfusion monitoring
Free flap
Microvascular head and neck reconstruction
Oxygen-2-see analysis system
Journal
Clinical oral investigations
ISSN: 1436-3771
Titre abrégé: Clin Oral Investig
Pays: Germany
ID NLM: 9707115
Informations de publication
Date de publication:
Sep 2023
Sep 2023
Historique:
received:
18
05
2023
accepted:
17
07
2023
medline:
11
9
2023
pubmed:
31
7
2023
entrez:
31
7
2023
Statut:
ppublish
Résumé
Postoperative flap monitoring is essential in oral microvascular reconstruction for timely detection of vascular compromise. This study investigated the use of attached surface probes for the oxygen-2-see (O2C) analysis system (LEA Medizintechnik, Germany) for intraoral flap perfusion monitoring. The study included 30 patients who underwent oral reconstruction with a microvascular radial-free forearm flap (RFFF) or anterolateral thigh flap (ALTF) between 2020 and 2022. Flap perfusion was measured with attached (3-mm measurement depth) and unattached surface probes (2- and 8-mm measurement depths) for the O2C analysis system at 0, 12, 24, 36, and 48 h postoperatively. Flap perfusion monitoring with attached surface probes was evaluated for cut-off values for flap blood flow, hemoglobin concentration, and hemoglobin oxygen saturation indicative of vascular compromise and for accuracy and concordance with unattached surface probes. Three RFFFs were successfully revised, and one ALTF was unsuccessfully revised. The cut-off values indicative of vascular compromise for flap perfusion monitoring with attached surface probes were for RFFF and ALTF: blood flow < 60 arbitrary units (AU) and < 40AU, hemoglobin concentration > 100AU and > 80AU (both > 10% increase), and hemoglobin oxygen saturation < 40% and < 30%. Flap perfusion monitoring with attached surface probes yielded a 97.1% accuracy and a Cohen's kappa of 0.653 (p < 0.001). Flap perfusion monitoring with attached surface probes for the O2C analysis system detected vascular compromise accurately and concordantly with unattached surface probes. Attached surface probes for the O2C analysis system are a feasible option for intraoral flap perfusion monitoring.
Identifiants
pubmed: 37522990
doi: 10.1007/s00784-023-05177-x
pii: 10.1007/s00784-023-05177-x
pmc: PMC10492739
doi:
Substances chimiques
Hemoglobins
0
Types de publication
Journal Article
Langues
eng
Pagination
5577-5585Informations de copyright
© 2023. The Author(s).
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