Optical Surgical Probe for Assessing Human Oral Mucosa Graft Vascularization

描述（由申请人提供）：破坏性和毁容的面部损伤可能导致枪伤和机动车事故，以及从头部和颈部或乳房的癌症手术。最先进的重建手术涉及组织的远距离转移，包括骨、骨膜、皮肤、肌肉和脉管系统，然后将预先存在的血管与移植组织进行显微外科吻合，称为游离或埋藏皮瓣。本课题旨在研制一种定量监测重建组织血流灌注和氧合的光学仪器。放置在组织移植物内（或顶部）的四个光纤组织贴片连接到血液动力学监测器，测量每个位置的氧合和血液流速：1.在供血动脉处; 2.在出口静脉; 3.在fap的毛细血管床内;和4。在皮肤表面。每个探头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能够从主观的、非定量的皮瓣健康评估过渡到直接定量的皮瓣健康测量。 将进行两项猪模型研究。第一项研究涉及手术创建一个包含一个动脉流入和一个静脉流出的游离皮瓣。一种封堵器， 明确限定的闭塞量（动脉或静脉）将用于闭塞血管，同时在皮瓣内的四个不同位置处同时获得血流和氧合测量值：动脉处、静脉处、皮瓣床内和皮肤处。这些研究将是短期的非生存程序。在第二项研究中，将创建包含植入的光学装置的组织瓣，并用于在手术后一周内如前所述监测四个部位的瓣活力。

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.