Near-infrared spectral imaging enables noninvasive skin flap examination

Researchers at the National Research Council Canada (Ottawa, ON, Canada) report preclinical results showing the potential of near-infrared (NIR) spectral imaging for intra-operative skin flap assessment.

Skin flaps are typically used to cover areas of tissue loss or defects that arise as a result of traumatic injury, reconstruction after cancer excision, and repair of congenital defects—and require post-operative monitoring to ensure that they do not fail. Most failures arise from circulatory complications where either the arterial blood supply to the flap is blocked or insufficient to support the flap tissue or venous drainage of the flap is compromised.

NIR spectral imaging enables surgeons to noninvasively examine skin flaps during surgery and in the early post-operative period. The NIR technique can be used to detect and localize blood supply-related complications as well as give real-time feedback to the surgeon as they try to resolve the complication.

"We also show that using estimates of tissue hemoglobin oxygen saturation, imaging measurements made during surgery and in the early post-operative period are highly predictive of the outcome of the flap tissue with specificities and sensitivities exceeding 85%," states Dr. Mike Sowa, who led the research team.

Oxygenation imaging immediately after surgery shows good predictive power for tissue necrosis. The prediction accuracy of the oxygen saturation parameter improves as measurements are made later in the post-operative period and becomes an excellent predictor of outcome when measurements are made one or two hours after the surgery. This method is highly capable of predicting the fate of flap tissues.

The work has been published in the Journal of Near Infrared Spectroscopy; for more information, please visit http://www.impublications.com/content/abstract?code=J20_0601.

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