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DOI: 10.1055/s-0031-1281521
The Use of Visible Light Spectroscopy to Measure Tissue Oxygenation in Free Flap Reconstruction
Publication History
Publication Date:
29 June 2011 (online)
ABSTRACT
The loss of a free flap is a feared complication for both the surgeon and the patient. Early recognition of vascular compromise has been shown to provide the best chance for flap salvage. The ideal monitoring technique for perioperative free flap ischemia would be noninvasive, continuous, and reliable. Visible light spectroscopy (VLS) was evaluated as a new method for predicting ischemia in microvascular cutaneous soft tissue free flaps. In an Institutional Review Board-approved prospective trial, 12 patients were monitored after free flap reconstructions. The tissue hemoglobin oxygen saturation (StO2) and total hemoglobin concentration (THB) of 12 flaps were continuously monitored using VLS for 72 hours postoperatively. Out of these 12 flaps 11 were transplanted successfully and 1 flap loss occurred. The StO2 was 48.99% and the THB was 46.74% for the 12 flaps. There was no significant difference in these values among the flaps. For the single flap loss, the device accurately reflected the ischemic drop in StO2 indicating drastic tissue ischemia at 6 hours postoperatively before the disappearance of implantable Doppler signals or clinical signs of flap compromise. VLS, a continuous, noninvasive, and localized method to monitor oxygenation, appeared to predict early ischemic complications after free flap reconstruction.
KEYWORDS
Visible light spectroscopy - free flap monitoring - free flap reconstruction - postoperative monitoring
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Howard T WangM.D.
Chief, Division of Plastic and Reconstructive Surgery
7703 Floyd Curl Drive, San Antonio, TX 78229-3900
Email: wanght@uthscsa.edu