Optical Surgical Probe for Assessing Human Oral Mucosa Graft Vascularization

描述（由申请人提供）：毁灭性和毁容的面部损伤可由枪伤和机动车事故以及头颈部或乳房的癌症手术引起。最先进的重建手术包括骨、骨膜、皮肤、肌肉和血管等组织的远端转移，然后将已有的血管与移植组织进行显微外科吻合，称为游离皮瓣或埋地皮瓣。我们提出研制一种用于重建组织血流灌注和氧合定量监测的光学仪器。放置在组织移植物内部（或顶部）的四个纤维组织贴片连接到血流动力学监测仪，测量每个位置的氧合和血流速率。在供血动脉上；2. 在出脉处；3. 在fap的毛细管床内；和4。在皮肤表面。每个探针将为外科医生提供血管流速、总血容量（血红蛋白浓度）和血氧的直接测量。这些测量将使显微外科医生从主观的、非定量的皮瓣健康评估过渡到对皮瓣健康的直接定量测量。将进行两项猪模型研究。第一项研究涉及外科手术创建一个自由皮瓣，其中包含单个流入动脉和单个流出静脉。闭塞装置：适用的闭塞装置

DESCRIPTION (provided by applicant): Devastating and disfiguring facial injuries can result from gunshot wounds and motor vehicle accidents as well as from cancer surgeries of the head and neck or breast. The most advanced reconstructive procedures involve distant transfer of tissue including bone, periosteum, skin, muscle and vasculature followed microsurgical anastomosis of pre-existing blood vessels to the grafted tissue, referred to as free or buried flaps. We propose to develop an optical instrument that quantitative monitoring of reconstructive tissue blood perfusion and oxygenation. Four fiberoptic tissue-patches placed within (or atop) tissue grafts connect to the hemodynamic monitor measuring oxygenation and blood flow rate at each location: 1. At a feeding artery; 2. At the exiting vein; 3. Within the capillary bed of the fap; and 4. At the surface of the skin. Each probe will provide the surgeon with direct measures of the rate of vascular flow, total blood volume (hemoglobin concentration) and the blood oxygenation. These measurements will enable the microsurgeon to transit from subjective, non-quantitative assessment of flap health to direct quantitative measurements of flap health. Two pig model studies will be performed. The first study involves surgical creation of a free flap containing a single artery for inflow and single vein for outflow. An occluding device that applies a well-defined amount of occlusion - either to the artery, or the vein - will be used to occlude th vessels while blood flow and oxygenation measurements will be obtained simultaneously at four different sites within the flap: at the artery, at the vein, within the flap bed, and at the skin. hese studies will be short non-survival procedures. In the second study, tissue flaps will be created containing the implanted optical devices and be used to monitor the flap viability at the four site as before, for one week post-surgery.