liu.seSök publikationer i DiVA
Ändra sökning
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Vascular Occlusion in a Porcine Flap Model: Effects on Blood Cell Concentration and Oxygenation.
Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Hand- och plastikkirurgiska kliniken US.
Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Hand- och plastikkirurgiska kliniken US.
Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Hudkliniken i Östergötland.
Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten.ORCID-id: 0000-0002-4245-7565
Visa övriga samt affilieringar
2017 (Engelska)Ingår i: Plastic and reconstructive surgery. Global open, ISSN 2169-7574, Vol. 5, nr 11, artikel-id e1531Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Venous congestion in skin flaps is difficult to detect. This study evaluated the ability of tissue viability imaging (TiVi) to measure changes in the concentration of red blood cells (CRBC), oxygenation, and heterogeneity during vascular provocations in a porcine fasciocutaneous flap model.

Methods: In 5 pigs, cranial gluteal artery perforator flaps were raised (8 flaps in 5 pigs). The arterial and venous blood flow was monitored with ultrasonic flow probes. CRBC, tissue oxygenation, and heterogeneity in the skin were monitored with TiVi during baseline, 50% and 100% venous occlusion, recovery, 100% arterial occlusion and final recovery, thereby simulating venous and arterial occlusion of a free fasciocutaneous flap. A laser Doppler probe was used as a reference for microvascular perfusion in the flap.

Results: During partial and complete venous occlusion, increases in CRBC were seen in different regions of the flap. They were more pronounced in the distal part. During complete arterial occlusion, CRBC decreased in all but the most distal parts of the flap. There were also increases in tissue oxygenation and heterogeneity during venous occlusion.

Conclusions: TiVi measures regional changes in CRBC in the skin of the flap during arterial and venous occlusion, as well as an increase in oxygenated hemoglobin during venous occlusion that may be the result of reduced metabolism and impaired delivery of oxygen to the tissue. TiVi may provide a promising method for measuring flap viability because it is hand-held, easy to-use, and provides spatial information on venous congestion.

Ort, förlag, år, upplaga, sidor
Wolters Kluwer, 2017. Vol. 5, nr 11, artikel-id e1531
Nationell ämneskategori
Radiologi och bildbehandling Kirurgi
Identifikatorer
URN: urn:nbn:se:liu:diva-145391DOI: 10.1097/GOX.0000000000001531PubMedID: 29263951Scopus ID: 2-s2.0-85038559789OAI: oai:DiVA.org:liu-145391DiVA, id: diva2:1186184
Tillgänglig från: 2018-02-27 Skapad: 2018-02-27 Senast uppdaterad: 2019-07-23Bibliografiskt granskad
Ingår i avhandling
1. Studies on Polarised Light Spectroscopy
Öppna denna publikation i ny flik eller fönster >>Studies on Polarised Light Spectroscopy
2019 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

This thesis project focuses on measurements of dermal microcirculation during vascular provocations with polarised light spectroscopy. This is done with a non-invasive method commercially available as Tissue viability imaging (TiVi) which measures concentration and oxygenation of red blood cells in the papillary dermis. Three studies were done with human subjects and one with an animal model, to validate and compare the TiVi technique with laser Doppler flowmetry, which is an established method of measuring dermal microcirculation.

The TiVi consists of a digital camera with polarisation filters in front of the flash and lens, with software for analysis of the picture. When taking a picture with the TiVi, the polarised light that is reflected on the skin surface is absorbed by the second filter over the lens (which is perpendicular to the first filter) but a portion of light penetrates the surface of the skin and is scattered when it is reflected on tissue components. This makes the light depolarised, passes the second filter, and produces a picture for analysis. The red blood cell (RBC) has a distinct absorption pattern that differs between red and green colour compared to melanin and other components of tissue. This difference is used by the software that calculates differences in each picture element and produces a measure of output which is proportional to the concentration of red blood cells. The oxygenation of RBC can also be calculated, as there is a difference in absorption depending on oxygen state.

The first paper takes up possible sources of error such as ambient light, and the angle and distance of the camera. The main experiment was to investigate how the local heating reaction is detected with TiVi compared to LDF.

In the second paper arterial and venous stasis are examined in healthy subjects with TiVi.

The Third paper is an animal study where skin flaps were raised on pigs, and the vascular pedicle is isolated to enable control of inflow and outflow of blood.The measurements were made during partial venous, total venous, and total arterial occlusion. The TiVi recorded changes in the concentration of RBC, oxygenation and heterogeneity and the results were compared with those of laser Doppler flowmetry.

In the fourth paper oxygenation and deoxygenation of RBC: s was studied. Studies were made on the forearms of healthy subjects who were exposed to arterial and venous occlusion. Simultaneous measurements were made with TiVi and Enhanced perfusion and oxygen saturation or EPOS, which is a new device that combines laser Doppler flowmetry and diffuse reflectance spectroscopy in one probe.

With TiVi, one can measure RBC concentration and oxygenation in the area of an entire picture or in one or multiple user defined regions of interest (ROI). Methods such as laser Doppler flowmetry makes single point measurements, which is a potential source of error both because of the heterogeneity of the microcirculation, and that the circulation be insufficient in the margins of the investigated area. TiVi has been able to measure venous stasis more accurately than laser Doppler flowmetry, and venous stasis is the more common reason for flaps to fail.

The TiVi is an accurate way to measure the concentration of RBC and trends in oxygenation of the dermal microcirculation. It has interesting possible applications for microvascular and dermatological research, monitoring of flaps, and diagnosis of peripheral vascular disease. Future clinical studies are needed as well as development of the user interface.  

Ort, förlag, år, upplaga, sidor
Linköping: Linköping University Electronic Press, 2019. s. 48
Serie
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1689
Nationell ämneskategori
Medicinsk laboratorie- och mätteknik
Identifikatorer
urn:nbn:se:liu:diva-159084 (URN)10.3384/diss.diva-159084 (DOI)9789176850428 (ISBN)
Disputation
2019-09-02, Belladonnasalen, Campus US, Linköping, 13:00 (Engelska)
Opponent
Handledare
Tillgänglig från: 2019-07-23 Skapad: 2019-07-23 Senast uppdaterad: 2019-09-18Bibliografiskt granskad

Open Access i DiVA

fulltext(492 kB)66 nedladdningar
Filinformation
Filnamn FULLTEXT01.pdfFilstorlek 492 kBChecksumma SHA-512
67b88d2f3bce5bc56a4a4301abb23bf85fc8b4dd1f4f9d8b3ebc6f12ec7e3eeddd2426a86ae30ea5ed15a5760c586c76ac033e2865cf3ee2ec986b2e8c07e13c
Typ fulltextMimetyp application/pdf

Övriga länkar

Förlagets fulltextPubMedScopus

Personposter BETA

Bergkvist, MaxZötterman, JohanHenricson, JoakimIredahl, FredrikTesselaar, ErikFarnebo, Simon

Sök vidare i DiVA

Av författaren/redaktören
Bergkvist, MaxZötterman, JohanHenricson, JoakimIredahl, FredrikTesselaar, ErikFarnebo, Simon
Av organisationen
Avdelningen för Kirurgi, Ortopedi och OnkologiMedicinska fakultetenHand- och plastikkirurgiska kliniken USAvdelningen för kliniska vetenskaperHudkliniken i ÖstergötlandRadiofysikavdelningen US
Radiologi och bildbehandlingKirurgi

Sök vidare utanför DiVA

GoogleGoogle Scholar
Totalt: 66 nedladdningar
Antalet nedladdningar är summan av nedladdningar för alla fulltexter. Det kan inkludera t.ex tidigare versioner som nu inte längre är tillgängliga.

doi
pubmed
urn-nbn

Altmetricpoäng

doi
pubmed
urn-nbn
Totalt: 508 träffar
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf