Near-infrared spectroscopy: Continuous, objective surveillance for face transplant success

Face transplantation carries a critical risk of vascular occlusion. Traditional monitoring relies on subjective clinical signs, which may detect compromise after irreversible ischemia. We report the first application of continuous near-infrared spectroscopy (NIRS) for postoperative monitoring in a partial face transplant recipient. Over ten days, NIRS identified 51 subclinical perfusion events (hemodynamic, positional, or mixed), enabling prompt non-surgical rescue. Regional oxygen saturation (rSO₂) drops preceded clinical signs, guiding fluid resuscitation and patient repositioning. No graft loss occurred. Continuous NIRS oximetry provides objective, real-time data that complements clinical examination and may improve allograft survival.