Becker Philipp, Blatt Sebastian, Pabst Andreas, Heimes Diana, Al-Nawas Bilal, Kämmerer Peer W, Thiem Daniel G E
Department of Oral and Maxillofacial Surgery, Federal Armed Forces Hospital, Rübenacherstr. 170, 56072 Koblenz, Germany.
Department of Oral and Maxillofacial Surgery, University Medical Centre Mainz, 55131 Mainz, Germany.
J Clin Med. 2022 Jul 16;11(14):4134. doi: 10.3390/jcm11144134.
To reduce microvascular free flap failure (MFF), monitoring is crucial for the early detection of malperfusion and allows timely salvage. Therefore, the aim of this study was to evaluate hyperspectral imaging (HSI) in comparison to micro-Doppler sonography (MDS) to monitor MFF perfusion in an in vivo rodent model. Bilateral groin flaps were raised on 20 Sprague−Dawley rats. The femoral artery was transected on the trial side and re-anastomosed. Flaps and anastomoses were assessed before, during, and after the period of ischemia every ten minutes for overall 60 min using HSI and MDS. The contralateral sides’ flaps served as controls. Tissue-oxygenation saturation (StO2), near-infrared perfusion index (NPI), hemoglobin (THI), and water distribution (TWI) were assessed by HSI, while blood flow was assessed by MDS. HSI correlates with the MDS signal in the case of sufficient and completely interrupted perfusion. HSI was able to validly and reproducibly detect tissue perfusion status using StO2 and NPI. After 40 min, flap perfusion decreased due to the general aggravation of hemodynamic circulatory situation, which resulted in a significant drop of StO2 (p < 0.005) and NPI (p < 0.005), whereas the Doppler signal remained unchanged. In accordance, HSI might be suitable to detect MFF general complications in an early stage and further decrease MFF failure rates, whereas MDS may only be used for direct complications at the anastomose site.
为减少微血管游离皮瓣失败（MFF），监测对于早期发现灌注不良并实现及时挽救至关重要。因此，本研究的目的是在体内啮齿动物模型中，将高光谱成像（HSI）与微型多普勒超声（MDS）进行比较，以监测MFF灌注情况。在20只Sprague-Dawley大鼠身上掀起双侧腹股沟皮瓣。在试验侧切断股动脉并重新吻合。使用HSI和MDS，在缺血期前、中、后每隔10分钟对皮瓣和吻合口进行评估，共评估60分钟。对侧皮瓣作为对照。通过HSI评估组织氧饱和度（StO2）、近红外灌注指数（NPI）、血红蛋白（THI）和水分布（TWI），而通过MDS评估血流。在灌注充足和完全中断的情况下，HSI与MDS信号相关。HSI能够使用StO2和NPI有效且可重复地检测组织灌注状态。40分钟后，由于血流动力学循环状况普遍恶化，皮瓣灌注下降，导致StO2（p < 0.005）和NPI（p < 0.005）显著下降，而多普勒信号保持不变。因此，HSI可能适合在早期检测MFF的一般并发症并进一步降低MFF失败率，而MDS可能仅用于吻合口部位的直接并发症。
