The Use of Visible Light Spectroscopy to Measure Tissue Oxygenation in Free Flap Reconstruction
The Use of Visible Light Spectroscopy to Measure Tissue Oxygenation in Free Flap Reconstruction
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DOI：
10.1055/s-0031-1281521
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发表时间：
2011-09-01
影响因子：
2.1
通讯作者：
Wang, Howard T.
中科院分区：
文献类型：
--
作者：
Cornejo, Agustin;Rodriguez, Thomas;Wang, Howard T.
对于外科医生和患者来说，游离皮瓣的丢失都是一个令人担忧的并发症。及早认识到血管受损是挽救皮瓣的最佳时机。无创、连续、可靠的是理想的围手术期游离皮瓣缺血监测技术。可见光光谱(VLS)是一种预测微血管皮肤软组织瓣缺血的新方法。在一项机构审查委员会批准的前瞻性试验中，对12名患者进行了游离皮瓣重建后的监测。用VLS连续监测12个皮瓣术后72h的组织氧饱和度(sto(2))和总血红蛋白浓度(THb)。12块皮瓣移植成功11块，1块皮瓣丢失。12个皮瓣术中吻合口占48.99%，吻合口占46.74%。这些值在不同的皮瓣间无显著差异。对于单个皮瓣的丢失，该装置准确地反映了术后6h在可植入的多普勒信号消失或临床皮瓣受损迹象消失之前，STO(2)的缺血性下降，表明严重的组织缺血。VLS是一种连续、非侵入性和局部监测氧合的方法，似乎可以预测游离皮瓣重建后的早期缺血并发症。
The loss of a free flap is a feared complication for both the surgeon and the patient. Early recognition of vascular compromise has been shown to provide the best chance for flap salvage. The ideal monitoring technique for perioperative free flap ischemia would be noninvasive, continuous, and reliable. Visible light spectroscopy (VLS) was evaluated as a new method for predicting ischemia in microvascular cutaneous soft tissue free flaps. In an Institutional Review Board-approved prospective trial, 12 patients were monitored after free flap reconstructions. The tissue hemoglobin oxygen saturation (StO(2)) and total hemoglobin concentration (THB) of 12 flaps were continuously monitored using VLS for 72 hours postoperatively. Out of these 12 flaps 11 were transplanted successfully and 1 flap loss occurred. The StO(2) was 48.99% and the THB was 46.74% for the 12 flaps. There was no significant difference in these values among the flaps. For the single flap loss, the device accurately reflected the ischemic drop in StO(2) indicating drastic tissue ischemia at 6 hours postoperatively before the disappearance of implantable Doppler signals or clinical signs of flap compromise. VLS, a continuous, noninvasive, and localized method to monitor oxygenation, appeared to predict early ischemic complications after free flap reconstruction.