Optical Surgical Probe for Assessing Human Oral Mucosa Graft Vascularization

描述（由申请人提供）：本提案的主要目标是开发一种基于漫射相关光谱（DCS）的新型灌注监测装置（PMD），这将使显微外科医生能够评估埋藏（预层压）皮瓣的血管化水平和移植微血管移植物的成功灌注。PMD将把目前对皮瓣血管化的评估从主观转变为直接的定量测定。目前临床上还没有一种被广泛接受的方法来测量埋地皮瓣的血管化情况或移植成功的微血管移植的灌注情况。PMD将满足这一需求。PMD利用最近可用的紧凑型低成本光源、固态探测器和cpu来简化和小型化埋地皮瓣血管化和成功移植微血管移植灌注的测量。这项技术的发展对事故受害者和受伤的士兵来说都是至关重要的，他们已经带着复杂的颌面损伤回家了。这些损伤导致毁灭性的软组织缺损，即唇部撕脱，这需要创新的手术方法，包括使用组织工程与微血管手术相结合来开发独特的预血管层压皮瓣，这对于重建复杂的人体解剖结构（如唇部）至关重要。由于这些独特的预层压皮瓣被埋在皮肤下，我们需要新的pmd来监测它们的血管化，以便在最佳时机收获它们用于移植。在这个使用DCS开发PMD的第一阶段建议中，我们将同时使用幻影和动物模型。

DESCRIPTION (provided by applicant): This proposal's main objective is the development of a novel Perfusion Monitoring Device (PMD) based upon diffuse correlation spectroscopy (DCS), which will enable microsurgeons to assess the level of vascularization of buried (prelaminated) flaps and the successful perfusion of transplanted microvascular grafts. The PMD will shift current assessment of buried flap vascularization from subjective to direct quantitative determination. Currently there is no widely accepted clinical method of measuring buried flap vascularization or successful transplanted microvascular graft perfusion. The PMD would fill this need. The PMD leverages the recent availability of compact low-cost light sources, solid state detectors, and CPUs to simplify and miniaturize the measurement of buried flap vascularization and successful transplanted microvascular graft perfusion. The development of this technology is critical both for accident victims and for wounded soldiers, who have returned home with complex maxillofacial injuries. These injuries result in devastating soft tissue defects, i.e. avulsion of the lips that require innovative surgical approaches that include the use of tissue engineering in combination with microvascular surgery to develop unique prevascularized prelaminated flaps that are critical in the reconstruction of complex human anatomy such as the lips. Since these unique prelaminated flaps are buried under the skin we need novel PMDs to monitor their vascularization so that they can be harvested for transplantation at the most optimal moment. We will use both phantoms and an animal model in this Phase I proposal for the development of the PMD using DCS. PUBLIC HEALTH RELEVANCE: Severe facial disfigurement can result from accidents and surgical treatment of head and neck cancers. Loss of lips is severely debilitating for victims, resulting not only in disfigurement but also in loss of speech and the ability to eat and drink. Reconstruction of lips is extremely difficult because it is a composite tissue. Our collaborator, Dr. Stephen Feinberg of the University of Michigan, has pioneered a method of reconstructing such tissue. This method requires growth of tissue grafts beneath the skin typically in the back. There is a critical need for an optical instrument which enables the microsurgeon to assess when these grafts have developed a proper blood supply. We here propose to develop a simple optical tool, or perfusion monitoring device (PMD), to enable this assessment.