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The use of laser speckle contrast imaging to predict flap necrosis: An experimental study in a porcine flap model
Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery.
2019 (English)In: Journal of Plastic, Reconstructive & Aesthetic Surgery, ISSN 1748-6815, E-ISSN 1532-1959, Vol. 72, no 5, p. 771-777Article in journal (Refereed) Published
Abstract [en]

Background: We evaluated the use of laser speckle contrast imaging (LSCI) in the perioperative planning in reconstructive flap surgery. The aim of the study was to investigate whether LSCI can predict regions with a high risk of developing postoperative necrosis. Our hypothesis was that, perioperatively, such regions have perfusion values below a threshold value and show a negative perfusion trend. Methods: A porcine flap model based on the cranial gluteal artery perforator was used. Images were acquired before surgery, immediately after surgery (t = 0), after 30 min (t =30 min), and after 72h (t = 72 h). Regions of interest (ROIs) were chosen along the central axis of the flap. Clinical evaluation of the flap was made during each time point. Results: At t = 72 h, a demarcation line could be seen at a distance of 15.8 +/- 0.4 cm away from the proximal border of the flaps. At t =0, perfusion decreased gradually from the proximal to the distal ROI. At t =30 min, perfusion was significantly lower in the ROI distal to the final demarcation line than that at t = 0, and in all flaps, these ROIs had a perfusion amp;lt;25 PU. At t= 72 h, perfusion in the ROI proximal to this line returned to baseline levels, whereas perfusion in the distal ROI remained low. Conclusions: In our model, a decrease in perfusion during the first 30 min after surgery and a perfusion amp;lt;25 PU at t = 30 min was a predictor for tissue morbidity 72 h after surgery, which indicates that LSCI is a promising technique for perioperative monitoring in reconstructive flap surgery. (C) 2018 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons.

Place, publisher, year, edition, pages
ELSEVIER SCI LTD , 2019. Vol. 72, no 5, p. 771-777
Keywords [en]
Flap monitoring; Reconstructive surgery; Laser speckle contrast imaging; Partial flap necrosis
National Category
Surgery
Identifiers
URN: urn:nbn:se:liu:diva-156911DOI: 10.1016/j.bjps.2018.11.021ISI: 000464986400009PubMedID: 30711464OAI: oai:DiVA.org:liu-156911DiVA, id: diva2:1318765
Note

Funding Agencies|County of Ostergotland

Available from: 2019-05-28 Created: 2019-05-28 Last updated: 2019-10-29

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The full text will be freely available from 2020-01-03 12:28
Available from 2020-01-03 12:28

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Zötterman, JohanTesselaar, ErikFarnebo, Simon
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Division of Surgery, Orthopedics and OncologyFaculty of Medicine and Health SciencesDepartment of Hand and Plastic Surgery
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