Koolen Pieter G L, Li Zongxi, Roussakis Emmanuel, Paul Marek A, Ibrahim Ahmed M S, Matyal Robina, Huang Thomas, Evans Conor L, Lin Samuel J
Boston and Charlestown, Mass.; New Orleans, La.; and Amsterdam, The Netherlands.
From the Division of Plastic Surgery and the Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, and the Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School; the Division of Plastic and Reconstructive Surgery, Louisiana State University Health Sciences Center; and the Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center.
Plast Reconstr Surg. 2017 Jul;140(1):89-96. doi: 10.1097/PRS.0000000000003421.
Knowledge of tissue oxygenation status is fundamental in the prevention of postoperative flap failure. Recently, the authors introduced a novel oxygen-sensing paint-on bandage that incorporated an oxygen-sensing porphyrin with a commercially available liquid bandage matrix. In this study, the authors extend validation of their oxygen-sensing bandage by comparing it to the use of near-infrared tissue oximetry in addition to Clark electrode measurements.
The oxygen-sensing paint-on bandage was applied to the left hind limb in a rodent model. Simultaneously, a near-infrared imaging device and Clark electrode were attached to the right and left hind limbs, respectively. Tissue oxygenation was measured under normal, ischemic (aortic ligation), and reperfused conditions.
On average, the oxygen-sensing paint-on bandage measured a decrease in transdermal oxygenation from 85.2 mmHg to 64.1 mmHg upon aortic ligation. The oxygen-sensing dye restored at 81.2 mmHg after unclamping. Responses in both control groups demonstrated a similar trend. Physiologic changes from normal to ischemic and reperfused conditions were statistically significantly different in all three techniques (p < 0.001).
The authors' newly developed oxygen-sensing paint-on bandage exhibits a comparable trend in oxygenation recordings in a rat model similar to conventional oxygenation assessment techniques. This technique could potentially prove to be a valuable tool in the routine clinical management of flaps following free tissue transfer. Incorporating oxygen-sensing capabilities into a simple wound dressing material has the added benefit of providing both wound protection and constant wound oxygenation assessment.
了解组织氧合状态是预防术后皮瓣坏死的基础。最近，作者介绍了一种新型的氧敏感型涂抹式绷带，它将一种氧敏感卟啉与市售的液体绷带基质相结合。在本研究中，作者除了将其与克拉克电极测量法进行比较外，还通过与近红外组织血氧饱和度测定法进行比较，进一步验证了他们的氧敏感绷带。
将氧敏感型涂抹式绷带应用于啮齿动物模型的左后肢。同时，将近红外成像设备和克拉克电极分别连接到右后肢和左后肢。在正常、缺血（主动脉结扎）和再灌注条件下测量组织氧合情况。
平均而言，在主动脉结扎后，氧敏感型涂抹式绷带测得经皮氧合从85.2 mmHg降至64.1 mmHg。松开结扎后，氧敏感染料恢复到81.2 mmHg。两个对照组的反应也呈现出类似趋势。在所有三种技术中，从正常状态到缺血和再灌注状态的生理变化在统计学上有显著差异（p < 0.001）。
作者新开发的氧敏感型涂抹式绷带在大鼠模型中的氧合记录趋势与传统氧合评估技术相当。这项技术可能被证明是游离组织移植后皮瓣常规临床管理中的一个有价值的工具。将氧敏感功能整合到一种简单的伤口敷料材料中，还有提供伤口保护和持续伤口氧合评估的额外好处。
