Real-Time Assessment of Free Flap Capillary Circulation Using Videocapillaroscopy

Abstract

This trial is registered under the name "Real-time assessment of capillary circulation using video-capillaroscopy," University Hospital Medical Information Network identification number UMIN000041092 (https://center6.umin.ac.jp/cgiopen-bin/ctr_e/ctr_view.cgi?recptno=R000046920).

Dynamic Changes on Video-capillaroscopy and Potential Microsurgical Application: Temperature and Skin Surface Readings

“…We have successfully demonstrated preliminary results on the reliability of video-capillaroscopy for flap monitoring. 4 We depicted similar capillary densities (31.4 ± 5.7 number/mm 2 ) and flow velocities (252.7 ± 8.2 μm/s) before flap harvest and 2 hours after a successful anastomosis (30.9 ± 6.6. number/mm 2 ; 251.0 ± 19.8 μm/s). 4 Also, with this modality, images generated from a real-time video were useful to differentiate between arterial or venous thrombosis on a microcirculatory level.…”

“…4 We achieved real-time flap monitoring by directly visualizing the flap’s skin capillary microcirculation, but the impact of the skin temperature on video-capillaroscopy was not evaluated. 4 Thus, to evaluate the impact of temperature during video-capillaroscopy monitoring, we analyzed video-capillaroscopy findings on different skin areas often used for flap harvest at normal and lower body temperatures.…”

Characteristics and Limitations of Video-capillaroscopy in Reconstructive Microsurgery for Different Histologic Components of Flaps

“…Video-capillaroscopy is a noninvasive imaging modality that can be used to assess perfusion changes in the capillary microcirculation of flaps. 4 , 5 Nonetheless, its application during microsurgery can be limited due to the different histological features of certain flap components. For instance, in the skin papillary region, video-capillaroscopy evaluation near to the incisions was not possible.…”

“… 3 Previously, we have successfully captured real-time blood flow for flap perfusion assessment within 1-mm depth from the superficial layer using video-capillaroscopy. 4 – 6 Herein, we used video-capillaroscopy to assess different tissue components involved in microvascular surgery. Additionally, we reported the characteristics of our findings and conditions limiting the use of video-capillaroscopy.…”

“…3 Previously, we have successfully captured real-time blood flow for flap perfusion assessment within 1-mm depth from the superficial layer using video-capillaroscopy. [4][5][6] Herein, we used video-capillaroscopy to assess different tissue components involved in Joseph M. Escandón, MD* Arbab Mohammad, MBBS † Chihiro Matsui, MD ‡ Takakuni Tanaka, DDS, PhD § William Wei-Kai Lao, MD ¶ Hattori Yoshitsugu, MD║ Yuki Matsui, MD, PhD** Hiroshi Mizuno, MD, PhD ‡ Summary: Indocyanine green, ultrasonography, and handheld Doppler can be used to evaluate blood flow at the donor and recipient site during microvascular reconstruction. However, these methods do not provide direct visualization and assessment of real-time blood flow.…”