Intraoperative Near-infrared Spectroscopy Can Predict Skin Flap Necrosis

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.