Tissue Oxygenation and Perfusion in Inferior Pedicle Reduction Mammaplasty by Near‐Infrared Reflection Spectroscopy and Color‐Coded Duplex Sonography
Tissue Oxygenation and Perfusion in Inferior Pedicle Reduction Mammaplasty by Near‐Infrared Reflection Spectroscopy and Color‐Coded Duplex Sonography
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通过近红外反射光谱和彩色编码双重超声检查进行下蒂缩小乳房整形术中的组织氧合和灌注
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发表时间：
2003
影响因子：
3.6
通讯作者：
R. Andresen
中科院分区：
文献类型：
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作者：
O. Scheufler;R. Andresen
患者;近红外反射光谱已经在各种实验和临床环境中用于无创研究组织灌注和氧合。它在整形手术中的应用直到最近才有报道。目前的研究使用近红外反射光谱监测下蒂缩乳成形术后乳房皮瓣的皮肤微循环。30例患者采用改良罗宾斯技术行双侧缩乳成形术。近红外反射光谱测量在术前和术后的几个确定的乳房位置进行。反射光谱系统能够检测总血红蛋白的绝对值（毫克/毫升）和组织血红蛋白氧饱和度（百分比）。彩色编码双工超声用于观察真皮腺蒂下的营养血管，并测量供应乳头乳晕复合体的动脉的收缩峰值血流。检查反射光谱值在术后过程中的变化。分析正常和受损皮瓣灌注及创面愈合患者的反射光谱和双超声值的差异，并进行临床和超声评价。术前反射光谱值显示局部、区域和个体间的差异。术后随访2周，观察所有患者组织血红蛋白氧饱和度和总血红蛋白的特征性变化。反射光谱值在乳房和乳头乳晕皮肤之间有显著差异。创面愈合受损患者与创面愈合正常患者相比，组织血红蛋白氧饱和度显著降低，总血红蛋白显著升高。然而，下皮腺蒂动脉的收缩峰值血流并没有显示乳头乳晕复合体伤口愈合受损或正常的患者之间的差异。近红外反射光谱可以检测皮肤皮瓣中的血红蛋白含量和氧合。组织血红蛋白、血氧饱和度和总血红蛋白的变化反映了正常和病理性创面愈合过程中皮瓣血流动力学的变化。由于个体内部和个体之间存在相当大的差异，趋势值似乎优于单一测量值。虽然在这项研究中，近红外反射光谱能够在临床模型中区分正常和受损的皮瓣灌注，但其未来的意义可能是在自由皮瓣中早期检测血管损伤。
&NA; Near‐infrared reflection spectroscopy has been used in various experimental and clinical settings to investigate tissue perfusion and oxygenation noninvasively. Its application in plastic surgery has only recently been reported. The current study used near‐infrared reflection spectroscopy to monitor cutaneous microcirculation in breast skin flaps after inferior pedicle reduction mammaplasty. Thirty patients underwent bilateral reduction mammaplasty by a modified Robbins technique. Near‐infrared reflection spectroscopy measurements were performed preoperatively and postoperatively at several defined positions of the breast. The reflection spectroscopy system was capable of detecting absolute values of total hemoglobin in milligrams per milliliter of tissue and tissue hemoglobin oxygen saturation in percent. Color‐coded duplex sonography was used to visualize nutrient vessels of the inferior dermoglandular pedicle and to measure systolic peak flow in the arteries supplying the nippleareola complex. Reflection spectroscopy values were examined for changes during the postoperative course. Reflection spectroscopy and duplex sonography values were analyzed for differences between patients with normal and compromised skin flap perfusion and wound healing, which was assessed clinically and by ultrasound. Preoperative reflection spectroscopy values demonstrated local, regional, and interindividual variations. Postoperatively, characteristic changes of tissue hemoglobin oxygen saturation and total hemoglobin were observed in all patients during the 2‐week follow‐up. Reflection spectroscopy values differed significantly between breast and nipple‐areola skin. Tissue hemoglobin oxygen saturation was significantly lower, and total hemoglobin significantly higher, in patients with impaired wound healing compared with patients having normal wound healing. However, systolic peak flow in arteries of the inferior dermoglandular pedicle did not reveal differences between patients with impaired or normal wound healing of the nipple‐areola complex. Near‐infrared reflection spectroscopy allows the detection of hemoglobin content and oxygenation in skin flaps. Changes in tissue hemoglobin oxygen saturation and total hemoglobin reflect hemodynamic changes in skin flaps during normal and pathological wound healing. Because of considerable intraindividual and interindividual variations, trend values seem to be superior to single measurements. Although in this study, near‐infrared reflection spectroscopy was capable of distinguishing between normal and impaired perfusion in skin flaps in a clinical model, its future implication may be the early detection of vascular compromise in free flaps.
影响因子：
2.9
作者：
CHANCE, B;NIOKA, S;HOLTOM, G
通讯作者：
HOLTOM, G