The use of visible light spectroscopy to measure tissue oxygenation in free flap reconstruction

Agustin Cornejo, Thomas Rodriguez, Megan Steigelman, Stacy Stephenson, David E Sahar, Stephen M. Cohn, Joel E. Michalek, Howard T. Wang

Research output: Contribution to journalArticle

23 Scopus citations

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 (StO 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 StOas 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 StOindicating 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.

Original languageEnglish (US)
Pages (from-to)397-402
Number of pages6
JournalJournal of Reconstructive Microsurgery
Volume27
Issue number7
DOIs
StatePublished - 2011
Externally publishedYes

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Keywords

  • free flap monitoring
  • free flap reconstruction
  • postoperative monitoring
  • Visible light spectroscopy

ASJC Scopus subject areas

  • Surgery

Cite this

Cornejo, A., Rodriguez, T., Steigelman, M., Stephenson, S., Sahar, D. E., Cohn, S. M., Michalek, J. E., & Wang, H. T. (2011). The use of visible light spectroscopy to measure tissue oxygenation in free flap reconstruction. Journal of Reconstructive Microsurgery, 27(7), 397-402. https://doi.org/10.1055/s-0031-1281521