Please use this identifier to cite or link to this item:
http://doi.org/10.25358/openscience-6700
Authors: | Thiem, Daniel G. E. Römer, Paul Blatt, Sebastian Al-Nawas, Bilal Kämmerer, Peer W. |
Title: | New approach to the old challenge of free flap monitoring : hyperspectral imaging outperforms clinical assessment by earlier detection of perfusion failure |
Online publication date: | 17-Jan-2022 |
Year of first publication: | 2021 |
Language: | english |
Abstract: | In reconstructive surgery, free flap failure, especially in complex osteocutaneous reconstructions, represents a significant clinical burden. Therefore, the aim of the presented study was to assess hyperspectral imaging (HSI) for monitoring of free flaps compared to clinical monitoring. In a prospective, non-randomized clinical study, patients with free flap reconstruction of the oro-maxillofacial-complex were included. Monitoring was assessed clinically and by using hyperspectral imaging (TIVITA™ Tissue-System, DiaspectiveVision GmbH, Pepelow, Germany) to determine tissue-oxygen-saturation [StO2], near-infrared-perfusion-index [NPI], distribution of haemoglobin [THI] and water [TWI], and variance to an adjacent reference area (Δreference). A total of 54 primary and 11 secondary reconstructions were performed including fasciocutaneous and osteocutaneous flaps. Re-exploration was performed in 19 cases. A total of seven complete flap failures occurred, resulting in a 63% salvage rate. Mean time from flap inset to decision making for re-exploration based on clinical assessment was 23.1 ± 21.9 vs. 18.2 ± 19.4 h by the appearance of hyperspectral criteria indicating impaired perfusion (StO2 ≤ 32% OR StO2Δreference > −38% OR NPI ≤ 32.9 OR NPIΔreference ≥ −13.4%) resulting in a difference of 4.8 ± 5 h (p < 0.001). HSI seems able to detect perfusion compromise significantly earlier than clinical monitoring. These findings provide an interpretation aid for clinicians to simplify postoperative flap monitoring. |
DDC: | 610 Medizin 610 Medical sciences |
Institution: | Johannes Gutenberg-Universität Mainz |
Department: | FB 04 Medizin |
Place: | Mainz |
ROR: | https://ror.org/023b0x485 |
DOI: | http://doi.org/10.25358/openscience-6700 |
Version: | Published version |
Publication type: | Zeitschriftenaufsatz |
License: | CC BY |
Information on rights of use: | https://creativecommons.org/licenses/by/4.0/ |
Journal: | Journal of Personalized Medicine 11 11 |
Pages or article number: | 1101 |
Publisher: | MDPI |
Publisher place: | Basel |
Issue date: | 2021 |
ISSN: | 2075-4426 |
Publisher URL: | https://doi.org/10.3390/jpm11111101 |
Publisher DOI: | 10.3390/jpm11111101 |
Appears in collections: | JGU-Publikationen |
Files in This Item:
File | Description | Size | Format | ||
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new_approach_to_the_old_chall-20220111133923447.pdf | 3.07 MB | Adobe PDF | View/Open |