Near-Infrared Spectroscopy for Continuous Noninvasive Monitoring of Free Flap in Head and Neck Reconstruction: Systematic Review of the Literature and Personal Experience.

IF 1.2 4区 医学 Q3 SURGERY
Surgical Innovation Pub Date : 2023-12-01 Epub Date: 2023-10-25 DOI:10.1177/15533506231209128
Bianca Maria Festa, Andrea Costantino, Gian Marco Pace, Giuseppe Spriano, Armando De Virgilio
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引用次数: 0

Abstract

Background: Buried free flaps represent a reconstructive challenge concerning monitoring of vitality, which is fundamental for an early detection of flap failure and prompt surgical salvage. Many flap monitoring techniques have been developed over time, and there is still no consensus concerning the best monitoring technique for buried reconstructions.

Methods: We performed a systematic review of the literature on NIRS monitoring for head and neck free flaps. Moreover, we presented a case of orbital reconstruction through a buried free myo-fascial anterolateral tight flap (ALTF) in which postoperative monitoring was performed by means of NIRS.

Results: Four studies were included with a total of 200 monitored head and neck free flap reconstructions. Flap survival was reported in 96.5% of studies (n = 193/200) with a 3.5% of total flap failure rate (n = 7/200). We monitored the buried myo-fascial ALTF for 7 post-operative days measuring a regional oxygen saturation (rSO2) ranging from 55% to 72% (mean = 66%).

Conclusions: This device appeared to be an efficient choice for monitoring buried flaps, thanks to its ability to measure tissue perfusion deep under the skin, to the continuous availability of recorded data on the monitor, and to its low impact on the patient. Further prospective studies are advised in order to standardize this monitoring technique and define warning values.

近红外光谱用于头颈部重建中游离皮瓣的连续无创监测:文献和个人经验的系统回顾。
背景:埋藏的游离皮瓣是一项重建挑战,涉及到活力的监测,这对于早期发现皮瓣失效和及时进行手术挽救是至关重要的。随着时间的推移,许多皮瓣监测技术已经发展起来,但对于埋藏重建的最佳监测技术仍然没有达成共识。方法:我们对近红外监测头颈部游离皮瓣的文献进行了系统回顾。此外,我们还介绍了一个通过埋入式游离肌筋膜前外侧紧密皮瓣(ALTF)重建眼眶的病例,其中通过NIRS进行术后监测。96.5%的研究报告了皮瓣存活率(n=193/200),皮瓣总失败率为3.5%(n=7/200)。术后7天,我们监测了埋藏的肌筋膜ALTF,测量区域血氧饱和度(rSO2)在55%至72%(平均值=66%)之间,以及其对患者的低影响。建议进行进一步的前瞻性研究,以使这种监测技术标准化并确定警告值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Surgical Innovation
Surgical Innovation 医学-外科
CiteScore
2.90
自引率
0.00%
发文量
72
审稿时长
6-12 weeks
期刊介绍: Surgical Innovation (SRI) is a peer-reviewed bi-monthly journal focusing on minimally invasive surgical techniques, new instruments such as laparoscopes and endoscopes, and new technologies. SRI prepares surgeons to think and work in "the operating room of the future" through learning new techniques, understanding and adapting to new technologies, maintaining surgical competencies, and applying surgical outcomes data to their practices. This journal is a member of the Committee on Publication Ethics (COPE).
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