Clinical evaluation of flap viability with a dermal surface fluorometer

Area of Science:

• Plastic Surgery
• Biomedical Engineering
• Surgical Innovation

Background:

• Assessing flap viability is crucial in reconstructive surgery.
• Traditional methods for evaluating flap perfusion can be subjective or invasive.
• Objective monitoring of vascular perfusion is needed for improved patient outcomes.

Purpose of the Study:

• To evaluate the efficacy of a dermal surface fluorometer for monitoring vascular perfusion in surgical flaps.
• To establish a quantitative perfusion ratio for predicting flap viability.
• To assess the safety and utility of this minimally invasive technique in postoperative care.

Main Methods:

• A dermal surface fluorometer (Fluoroscan) was employed to measure fluorescence.
• Sodium fluorescein was administered intravenously to 22 patients undergoing reconstructive surgery.
• Quantitative fluorescence readings were obtained from various flap types and compared to normal skin controls to calculate a perfusion ratio.

Main Results:

• Partial flap necrosis occurred in 4 patients, correlating with low fluorescein perfusion measurements.
• A perfusion ratio of 15% or greater at 10 minutes post-injection accurately predicted tissue viability.
• The technique demonstrated no observed systemic reactions in patients.

Conclusions:

• A perfusion ratio threshold of 15% at 10 minutes post-injection reliably predicts flap viability.
• Dermal surface fluorometry offers a minimally invasive and accurate method for postoperative flap evaluation.
• This technique can significantly aid in the assessment of flap survival and guide clinical management.