Wireless wearable self-calibrated sensor for perfusion assessment of myocutaneous tissue

Abstract

Blood flow and perfusion monitoring are critical appraisal to ensure survival of tissue flap after reconstructive surgery. Many techniques have been developed over the years: from optical to chemical, invasive or not, they all have limitations in their price, risks and adaptiveness to the patient. A wireless wearable self-calibrated device, based on near infrared spectroscopy (NIRS) was developed for blood flow and perfusion monitoring contingent on tissue oxygen saturation (StO2). The use of such device is particularly relevant in the case of free flap myocutaneous reconstructive surgery; postoperative monitoring of the flap is crucial for a prompt intervention in case of thrombosis. Although failure rate is low, the rate of additional surgery following anastomosis problem is about 50%. NIRS has shown promising results for the monitoring of free flap, however lack of adaptation to its environment (ambient light) and users (body mass index (BMI), skin tone, alcohol and smoking habits or physical activity level) hinders the practical use of this technique. To overcome those limitations, a self-calibrated approach is introduced. Tested with is chaemia and cold water experiments on healthy subjects of different skin tones, its ability to personalize its calibration is demonstrated. Furthermore, using a vascular phantom, it is also able to detect pulses, differentiate venous and arterial coloured-like fluids with distinct clusters and detect significant changes in simulated partial venous occlusion. Placed in the trained classifier, partial occlusion data showed similar results between predicted and true classification. Further analysis from partial occlusion data showed that distinct clusters for 75% and 100% occlusion emerged.