Novel diffuse optics system for continuous tissue viability monitoring: extended recovery in vivo testing in a porcine flap model

In reconstructive surgery, the ability to detect blood flow interruptions to grafted tissue represents a critical step in preventing postsurgical complications. We have developed and pilot tested a compact, fiber-based device that combines two complimentary modalities-diffuse correlation spectroscopy (DCS) and diffuse reflectance spectroscopy-to quantitatively monitor blood perfusion. We present a proof-of-concept study on an in vivo porcine model (n=8). With a controllable arterial blood flow supply, occlusion studies (n=4) were performed on surgically isolated free flaps while the device simultaneously monitored blood flow through the supplying artery as well as flap perfusion from three orientations: the distal side of the flap and two transdermal channels. Further studies featuring long-term monitoring, arterial failure simulations, and venous failure simulations were performed on flaps that had undergone an anastomosis procedure (n=4). Additionally, benchtop verification of the DCS system was performed on liquid flow phantoms. Data revealed relationships between diffuse optical measures and state of occlusion as well as the ability to detect arterial and venous compromise. The compact construction of the device, along with its noninvasive and quantitative nature, would make this technology suitable for clinical translation.

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“…A portion of the results was reported in Refs. 20 and 21. Here, we present findings from the expanded data set.…”

Section: Introductionmentioning

confidence: 91%

Compact dual-mode diffuse optical system for blood perfusion monitoring in a porcine model of microvascular tissue flaps

et al. 2017

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“…The measurements were done on the artery, muscle and skin of the MF in a porcine model but only on two animals. A significant inconsistency in obtained measurements was noted and the authors concluded that further development work is needed 148,149 .…”

Section: Brief Description Of Monitoring Methodsmentioning

confidence: 99%

The use of sentinel skin islands for monitoring buried and semi-buried micro-vascular flaps. Part I: Summary and brief description of monitoring methods

Molitor¹,

Měšťák²,

Pink³

et al. 2021

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Micro-vascular flaps have been used for the repair of challenging defects for over 45 years. The risk of failure is reported to be around 5-10% which despite medical and technical advances in recent years remains essentially unchanged. Precise, continuous, sensitive and specific monitoring together with prompt notification of vascular compromise is crucial for the success of the procedure. In this review, we provide a classification and brief description of the reported methods for monitoring the micro-vascular flap and a summary of the benefits over direct visual monitoring. Over 40 different monitoring techniques have been reported but their comparative merits are not always obvious. One looks for early detection of a flap's compromise, improved flap salvage rate and a minimal false-positive or false-negative rate. The cost-effectiveness of any method should also be considered. Direct visualisation of the flap is the method most generally used and still seems to be the simplest, cheapest and most reliable method for flap monitoring. Considering the alternatives, only implantable Doppler ultrasound probes, near infrared spectroscopy and laser Doppler flowmetry have shown any evidence of improved flap salvage rates over direct visual monitoring.

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Novel diffuse optics system for continuous tissue viability monitoring: extended recovery in vivo testing in a porcine flap model

Cited by 2 publications

References 14 publications

Compact dual-mode diffuse optical system for blood perfusion monitoring in a porcine model of microvascular tissue flaps

Compact dual-mode diffuse optical system for blood perfusion monitoring in a porcine model of microvascular tissue flaps

The use of sentinel skin islands for monitoring buried and semi-buried micro-vascular flaps. Part I: Summary and brief description of monitoring methods

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