کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
4121017 1270383 2008 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Continuous postoperative monitoring of cutaneous free flaps using near infrared spectroscopy
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیماری های گوش و جراحی پلاستیک صورت
پیش نمایش صفحه اول مقاله
Continuous postoperative monitoring of cutaneous free flaps using near infrared spectroscopy
چکیده انگلیسی

SummaryReliable detection of circulatory compromise threatening free-flap viability is essential for prompt surgical intervention and flap salvage. Numerous techniques have been developed to address the issue of postoperative flap monitoring but none have achieved universal acceptance. Near infrared spectroscopy (NIRS) is a noninvasive technique that allows continuous monitoring of tissue oxygenation and perfusion. It is increasingly recognised to be a reliable method for flap viability assessment. This study was designed to investigate the ability of NIRS to detect and identify microvascular thrombosis endangering flap survival. To our knowledge, this is the first clinical evaluation of NIRS used for continuous monitoring of free flaps.MethodsFifty flaps used for autologous breast reconstruction in 48 patients were included in this prospective clinical study. NIRS was employed for 72-h continuous postoperative monitoring. The data were compared to findings of clinical assessments.ResultsTen flaps (20%) developed 13 anastomosis thromboses (two arterial and 11 venous). NIRS detected all cases of flow failure prior to clinical observation with no false positives or negatives. Based on consistent patterns of NIRS parameter changes, it was possible to differentiate between changes caused by arterial and venous thrombosis with accuracy before surgical re-exploration. The salvage rate was 70%. Overall flap viability was 94%.ConclusionsContinuous NIRS monitoring can reliably detect and identify early stages of arterial and venous thrombosis, and is a credible method for noninvasive postoperative flap surveillance. Based on these findings, we advocate its use for monitoring of flaps with a cutaneous component.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Plastic, Reconstructive & Aesthetic Surgery - Volume 61, Issue 1, January 2008, Pages 71–77
نویسندگان
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