Wireless wearable self-calibrated sensor for perfusion assessment of myocutaneous tissue
Wireless wearable self-calibrated sensor for perfusion assessment of myocutaneous tissue
复制标题
用于肌皮组织灌注评估的无线可穿戴自校准传感器
DOI：
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发表时间：
2016
期刊：
影响因子：
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通讯作者：
Benny P. L. Lo
中科院分区：
文献类型：
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作者：
M. Berthelot;Ching;Guang;Benny P. L. Lo
血流量和血流监测是保证组织瓣重建术后成活的关键指标。多年来，已经发展了许多技术：从光学到化学，无论是侵入性还是非侵入性，它们在价格、风险和对患者的适应性方面都有局限性。开发了一种基于近红外光谱(NIRS)的无线可穿戴式自校准装置，用于基于组织氧饱和度(StO2)的血流和血流灌注监测。这种装置的使用在游离皮瓣肌皮肤重建手术中尤其重要；术后监测皮瓣对于血栓形成情况下的及时干预是至关重要的。虽然失败率很低，但吻合口问题后再手术的比率约为50%。近红外光谱(NIRS)技术在游离瓣的监测中取得了很好的效果，但缺乏对环境(环境光线)和使用者(身体质量指数、肤色、酒精和吸烟习惯或体力活动水平)的适应，阻碍了这项技术的实际应用。为了克服这些限制，引入了一种自校准方法。在不同肤色的健康受试者上进行了贫血和冷水实验，证明了其个性化校准的能力。此外，使用血管模体，它还能够检测脉搏，区分具有不同簇的静脉和动脉颜色的液体，并检测模拟部分静脉闭塞的显著变化。在训练好的分类器中，部分遮挡数据在预测分类和真实分类中显示出相似的结果。对部分遮挡数据的进一步分析显示，75%和100%的遮挡出现了明显的簇。
Blood flow and perfusion monitoring are critical appraisal to ensure survival of tissue flap after reconstructive surgery. Many techniques have been developed over the years: from optical to chemical, invasive or not, they all have limitations in their price, risks and adaptiveness to the patient. A wireless wearable self-calibrated device, based on near infrared spectroscopy (NIRS) was developed for blood flow and perfusion monitoring contingent on tissue oxygen saturation (StO2). The use of such device is particularly relevant in the case of free flap myocutaneous reconstructive surgery; postoperative monitoring of the flap is crucial for a prompt intervention in case of thrombosis. Although failure rate is low, the rate of additional surgery following anastomosis problem is about 50%. NIRS has shown promising results for the monitoring of free flap, however lack of adaptation to its environment (ambient light) and users (body mass index (BMI), skin tone, alcohol and smoking habits or physical activity level) hinders the practical use of this technique. To overcome those limitations, a self-calibrated approach is introduced. Tested with is chaemia and cold water experiments on healthy subjects of different skin tones, its ability to personalize its calibration is demonstrated. Furthermore, using a vascular phantom, it is also able to detect pulses, differentiate venous and arterial coloured-like fluids with distinct clusters and detect significant changes in simulated partial venous occlusion. Placed in the trained classifier, partial occlusion data showed similar results between predicted and true classification. Further analysis from partial occlusion data showed that distinct clusters for 75% and 100% occlusion emerged.