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Evaluation of Sidestream Darkfield Microscopy for Real-Time Imaging Acellular Dermal Matrix Revascularization
Brent R DeGeorge1, J Bryce Olenczak, Patrick S Cottler
1From the Department of Plastic Surgery, University of Virginia Health System, Charlottesville, VA.
Annals of Plastic Surgery
|May 18, 2016
Summary
Sidestream darkfield microscopy safely assessed acellular dermal matrix (ADM) revascularization during breast reconstruction. This imaging technique revealed non-uniform vascularization within ADMs, with distinct differences between the border and central zones.
Area of Science:
- Biomedical Engineering
- Regenerative Medicine
- Plastic Surgery
Background:
- Acellular dermal matrices (ADMs) are crucial for soft tissue augmentation in breast reconstruction, relying on vascular ingrowth for success.
- Current intraoperative imaging methods are insufficient for evaluating ADM revascularization.
Purpose of the Study:
- To investigate the safety, feasibility, and efficacy of sidestream darkfield (SDF) microscopy for assessing ADM microvascular architecture during breast reconstruction.
- To compare vascularization within ADMs to native periprosthetic capsules.
Main Methods:
- SDF microscopy, a handheld device, was used intraoperatively in 8 patients undergoing 2-stage ADM-assisted breast reconstruction.
- The device assessed blood flow, vessel density, size, and branching patterns in the center and border zones of the ADM and native capsule.
Main Results:
- SDF image acquisition was safe, with no adverse events reported.
- Native capsules showed dense, layered vascular architecture.
- ADM-associated capsules exhibited non-uniform vascularization, with a well-perfused border zone and a poorly vascularized central zone.
Conclusions:
- Sidestream darkfield microscopy enables real-time intraoperative assessment of ADM revascularization.
- This technique can be used to compare vascularization across different ADMs and confirms that ADM capsules are not uniformly vascularized.
