Department of Surgery, Division of Surgical Oncology, University of Texas, Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9155, USA.
World J Surg Oncol. 2009 Nov 25;7:91. doi: 10.1186/1477-7819-7-91.
Flap necrosis and epidermolysis occurs in 18-30% of all mastectomies. Complications may be prevented by intra-operative detection of ischemia. Currently, no technique enables quantitative valuation of mastectomy skin perfusion. Optical Diffusion Imaging Spectroscopy (ViOptix T.Ox Tissue Oximeter) measures the ratio of oxyhemoglobin to deoxyhemoglobin over a 1 x 1 cm area to obtain a non-invasive measurement of perfusion (StO2).
This study evaluates the ability of ViOptix T.Ox Tissue Oximeter to predict mastectomy flap necrosis. StO2 measurements were taken at five points before and at completion of dissection in 10 patients. Data collected included: demographics, tumor size, flap length/thickness, co-morbidities, procedure length, and wound complications.
One patient experienced mastectomy skin flap necrosis. Five patients underwent immediate reconstruction, including the patient with necrosis. Statistically significant factors contributing to necrosis included reduction in medial flap StO2 (p = 0.0189), reduction in inferior flap StO2 (p = 0.003), and flap length (p = 0.009).
StO2 reductions may be utilized to identify impaired perfusion in mastectomy skin flaps.
皮瓣坏死和表皮松解在所有乳房切除术中有 18-30%的发生率。术中检测缺血可以预防并发症。目前，还没有技术可以对乳房切除术皮肤灌注进行定量评估。光扩散成像光谱（ViOptix T.Ox 组织血氧计）可测量 1 x 1cm 区域内的氧合血红蛋白与脱氧血红蛋白的比值，从而获得灌注（StO2）的非侵入性测量。
本研究评估了 ViOptix T.Ox 组织血氧计预测乳房切除术皮瓣坏死的能力。在 10 名患者中，在五个术前和五个术毕的部位进行了 StO2 测量。收集的数据包括：人口统计学资料、肿瘤大小、皮瓣长度/厚度、合并症、手术时间和伤口并发症。
一名患者发生乳房皮肤皮瓣坏死。五名患者接受了即刻重建，包括发生坏死的患者。导致坏死的统计学显著因素包括内侧皮瓣 StO2 降低（p = 0.0189）、下皮瓣 StO2 降低（p = 0.003）和皮瓣长度（p = 0.009）。
StO2 降低可能用于识别乳房切除术皮瓣灌注受损。
