Department of Oto-Rhino-Laryngology, Head and Neck Surgery "Otto Körner", Rostock University Medical Center, Doberaner Straße 137-139, 18057, Rostock, Germany.
Vision and Imaging Technologies, Fraunhofer Heinrich Hertz Institute HHI, Einsteinufer 37, 10587, Berlin, Germany.
Sci Rep. 2023 Jan 27;13(1):1532. doi: 10.1038/s41598-023-28277-w.
Flap loss through limited perfusion remains a major complication in reconstructive surgery. Continuous monitoring of perfusion will facilitate early detection of insufficient perfusion. Remote or imaging photoplethysmography (rPPG/iPPG) as a non-contact, non-ionizing, and non-invasive monitoring technique provides objective and reproducible information on physiological parameters. The aim of this study is to establish rPPG for intra- and postoperative monitoring of flap perfusion in patients undergoing reconstruction with free fasciocutaneous flaps (FFCF). We developed a monitoring algorithm for flap perfusion, which was evaluated in 15 patients. For 14 patients, ischemia of the FFCF in the forearm and successful reperfusion of the implanted FFCF was quantified based on the local signal. One FFCF showed no perfusion after reperfusion and devitalized in the course. Intraoperative monitoring of perfusion with rPPG provides objective and reproducible results. Therefore, rPPG is a promising technology for standard flap perfusion monitoring on low costs without the need for additional monitoring devices.
皮瓣灌注不足导致的皮瓣丧失仍然是重建手术中的一个主要并发症。持续监测灌注情况有助于早期发现灌注不足。远程或成像光体积描记术（rPPG/iPPG）作为一种非接触式、非电离性和非侵入性监测技术，提供了关于生理参数的客观和可重复的信息。本研究的目的是建立 rPPG，以用于接受游离筋膜皮瓣（FFCF）重建的患者的皮瓣灌注的术中及术后监测。我们开发了一种皮瓣灌注监测算法，并在 15 名患者中进行了评估。对于 14 名患者，基于局部信号定量评估了前臂 FFCF 的缺血情况和植入 FFCF 的成功再灌注情况。有一个 FFCF 在再灌注后没有灌注，并且在过程中失活了。rPPG 进行术中灌注监测可提供客观和可重复的结果。因此，rPPG 是一种很有前途的技术，可以在不使用额外监测设备的情况下，以低成本进行标准皮瓣灌注监测。
