Postoperative flap monitoring using Hyperspectral Imaging – A case series

 

Introduction The free and pedicled flap reconstruction for defects of the head and neck demands a postoperative flap monitoring routine. This task is usually performed by visual examination of the flap, doppler sonography and pinpricking. In case of impaired perfusion surgical revision of the flap is the only way to prevent necrosis. Hyperspectral imaging is a non-invasive optical method that can be used for tissue classification and can visualize perfusion and oxygenation of tissue.

Methods We presend a case series of 10 patients who underwent a flap reconstruction of the head and neck. Besides the regular flap monitoring HSI images were generated right after the flap harvest, as well as at the first and second postoperative day. We analysed 5 parameters (Tissue oxygen saturation (Tissue oxygen saturation, Tissue Hemoglobin Index, Organ Hemoglobin Index, NIR Perfusion Index; Tissue Water Index).

Results We could show a direct correlation of the HSI parameters and the vitality of the flap. Especially the Oxygen Saturation Index and the Perfusion Index qualified as reliable monitoring parameters.

Discussion HSI is a promising non-invasive technique for flap monitoring and is easy and fast applicable. A larger number of cases is necessary to proof the reliability of the imaging. In case this is proven the flap monitoring can be ensured fast, non-invasive and safely in the future.

Publication History

Article published online:
24 May 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag
Rüdigerstraße 14, 70469 Stuttgart, Germany