Autoren:	Thiem, Daniel G. E. Frick, Richard W. Goetze, Elisabeth Gielisch, Matthias Al-Nawas, Bilal Kämmerer, Peer W.
Titel:	Hyperspectral analysis for perioperative perfusion monitoring : a clinical feasibility study on free and pedicled flaps
Online-Publikationsdatum:	17-Mai-2021
Erscheinungsdatum:	2021
Sprache des Dokuments:	Englisch
Zusammenfassung/Abstract:	OBJECTIVES In reconstructive surgery, flap monitoring is crucial for early identification of perfusion problems. Using hyperspectral imaging (HSI), this clinical study aimed to develop a non-invasive, objective approach for perfusion monitoring of free and pedicled flaps. MATERIAL AND METHODS HSI of 22 free (FF) and 8 pedicled flaps (PF) in 30 patients was recorded over time. Parameters assessed were tissue oxygenation/superficial perfusion (0–1 mm) (StO2 (0–100%)), near-infrared perfusion/deep perfusion (0–4 mm) (NIR (0–100)), distribution of haemoglobin (THI (0–100)), and water (TWI (0–100)). Measurements up to 72 h were correlated to clinical assessment. RESULTS Directly after flap inset, mean StO2 was significantly higher in FF (70.3 ± 13.6%) compared with PF 56.2 ± 14.2% (p = 0.05), whereas NIR, THI, and TWI were similar (NIR_p = 0.82, THI_p = 0.97, TWI_p = 0.27). After 24 h, StO2, NIR, THI, and TWI did not differ between FF and PF. After 48 h, StO2, NIR, and TWI did not differ between FF and PF whereas THI was significantly increased in FF compared with PF(p = 0.001). In three FF, perfusion decreased clinically and in HSI, 36(1), 40(2), 5(3), and 61(3) h after flap inset which was followed by prompt intervention. CONCLUSIONS StO2 < 40%, NIR < 25/100, and THI < 40/100 indicated arterial occlusion, whereas venous problems revealed an increase of THI. In comparison with FF, perfusion parameters of PF were decreased after flap transfer but remained similar to FF later on. CLINICAL RELEVANCE HSI provides objective and non-invasive perfusion monitoring after flap transplantation in accordance to the clinical situation. With HSI, signs of deterioration can be detected hours before clinical diagnosis.
DDC-Sachgruppe:	610 Medizin 610 Medical sciences
Veröffentlichende Institution:	Johannes Gutenberg-Universität Mainz
Organisationseinheit:	FB 04 Medizin
Veröffentlichungsort:	Mainz
ROR:	https://ror.org/023b0x485
DOI:	http://doi.org/10.25358/openscience-5884
Version:	Published version
Publikationstyp:	Zeitschriftenaufsatz
Nutzungsrechte:	CC BY
Informationen zu den Nutzungsrechten:	https://creativecommons.org/licenses/by/4.0/
Zeitschrift:	Clinical oral investigations 25
Seitenzahl oder Artikelnummer:	933 945
Verlag:	Springer
Verlagsort:	Berlin u.a.
Erscheinungsdatum:	2021
ISSN:	1436-3771
URL der Originalveröffentlichung:	https://doi.org/10.1007/s00784-020-03382-6
DOI der Originalveröffentlichung:	10.1007/s00784-020-03382-6
Enthalten in den Sammlungen:	JGU-Publikationen