Department of Applied Physical Sciences, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Department of Materials Science and Engineering, Querrey Simpson Institute for Bioelectronics, Northwestern University, Chicago, Illinois.
J Reconstr Microsurg. 2022 May;38(4):321-327. doi: 10.1055/s-0041-1732361. Epub 2021 Sep 22.
Current near-infrared spectroscopy (NIRS)-based systems for continuous flap monitoring are limited to flaps which carry a cutaneous paddle. As such, this useful and reliable technology has not previously been applicable to muscle-only free flaps where other modalities with substantial limitations continue to be utilized.
We present the first NIRS probe which allows continuous monitoring of local tissue oxygen saturation (StO) directly within the substance of muscle tissue. This probe is flexible, subcentimeter in scale, waterproof, biocompatible, and is fitted with resorbable barbs which facilitate temporary autostabilization followed by easy atraumatic removal. This novel device was compared with a ViOptix T.Ox monitor in a porcine rectus abdominus myocutaneous flap model of arterial and venous occlusions. During these experiments, the T.Ox device was affixed to the skin paddle, while the novel probe was within the muscle component of the same flap.
The intramuscular NIRS device and skin-mounted ViOptix T.Ox devices produced very similar StO tracings throughout the vascular clamping events, with obvious and parallel changes occurring upon vascular clamping and release. The normalized cross-correlation at zero lag describing correspondence between the novel intramuscular NIRS and T.Ox devices was >0.99.
This novel intramuscular NIRS probe offers continuous monitoring of oxygen saturation within muscle flaps. This experiment demonstrates the potential suitability of this intramuscular NIRS probe for the task of muscle-only free flap monitoring, where NIRS has not previously been applicable. Testing in the clinical environment is necessary to assess durability and reliability.
目前基于近红外光谱（NIRS）的连续皮瓣监测系统仅限于带有皮瓣的皮瓣。因此，这项有用且可靠的技术以前不适用于仅带有肌肉的游离皮瓣，而其他具有实质性限制的模式继续被使用。
我们介绍了第一个允许直接在肌肉组织内部监测局部组织氧饱和度（StO）的 NIRS 探头。该探头具有柔韧性、亚厘米级尺寸、防水性、生物相容性，并配有可吸收倒刺，可实现临时自动稳定，然后轻松无创去除。该新型装置与 ViOptix T.Ox 监测器在猪腹直肌肌皮瓣的动脉和静脉阻塞模型中进行了比较。在这些实验中，T.Ox 设备固定在皮瓣上，而新型探头则位于同一皮瓣的肌肉部分。
在整个血管夹闭事件中，肌肉内 NIRS 设备和皮肤安装的 ViOptix T.Ox 设备产生的 StO 轨迹非常相似，在血管夹闭和释放时会出现明显且平行的变化。描述新型肌肉内 NIRS 和 T.Ox 设备之间对应关系的零延迟归一化互相关系数>0.99。
这种新型的肌肉内 NIRS 探头可连续监测肌肉皮瓣内的氧饱和度。该实验证明了这种新型肌肉内 NIRS 探头在以前不适用于的仅肌肉游离皮瓣监测任务中的适用性。在临床环境中进行测试是评估耐用性和可靠性的必要条件。
