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Intraoperative Near-infrared Spectroscopy Can Predict Skin Flap Necrosis.

W F Hill1, K Kinaschuk2, C Temple-Oberle1,3

  • 1From the Section of Plastic Surgery, University of Calgary, Cumming School of Medicine, Calgary, AB, Canada.

Plastic and Reconstructive Surgery. Global Open
|March 27, 2024
PubMed
Summary
This summary is machine-generated.

Near-infrared spectroscopy (NIRS) can detect tissue perfusion differences during surgery. Low tissue oxygen saturation (StO2) measurements accurately predict skin flap necrosis (SFN).

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Area of Science:

  • Biomedical Engineering
  • Surgical Oncology
  • Medical Devices

Background:

  • Near-infrared spectroscopy (NIRS) is a non-invasive optical technique.
  • NIRS has shown potential for assessing tissue oxygenation.
  • Intraoperative tissue perfusion monitoring is crucial for flap viability.

Purpose of the Study:

  • To validate NIRS's ability to detect clinically relevant differences in intraoperative tissue perfusion.
  • To assess the correlation between tissue oxygen saturation (StO2) and skin flap necrosis (SFN).

Main Methods:

  • 102 patients undergoing oncologic resection with flap reconstruction were analyzed.
  • Clinicians were blinded to intraoperative StO2 measurements obtained via NIRS.
  • StO2 measurements were taken from control, at-risk, and necrotic flap areas.

Main Results:

  • 17.6% of patients developed SFN.
  • Mean intraoperative StO2 was 74.8% (control), 70.9% (at-risk), and 54.3% (SFN).
  • StO2 ≤ 60% was 96% specific for SFN; StO2 > 85% was 96% sensitive to rule out SFN.

Conclusions:

  • NIRS objectively assesses skin flap oxygenation and tissue perfusion.
  • Intraoperative StO2 monitoring can predict postoperative SFN development.
  • NIRS is a valuable tool for improving flap reconstruction outcomes.