Postoperative Monitoring by Near-Infrared Spectroscopy in Transferred Free Tissue

DOI 機関リポジトリ 機関リポジトリ (HANDLE) Web Site 参考文献15件 オープンアクセス
  • Fujita Tamaki
    Department of Surgery, Plastic and Reconstructive Surgery Division, University of Miyazaki Faculty of Medicine
  • Ito Hiroshi
    Department of Surgery, Plastic and Reconstructive Surgery Division, University of Miyazaki Faculty of Medicine
  • Ito Noriko
    Department of Surgery, Plastic and Reconstructive Surgery Division, University of Miyazaki Faculty of Medicine
  • Nakai Michikazu
    Department of Statistics and Data Management, Faculty of Medicine, University of Miyazaki

書誌事項

公開日
2025-12-01
資源種別
journal article
DOI
  • 10.36748/ijswc.25-00010
公開者
一般社団法人 日本創傷外科学会

説明

Background: Near-infrared spectroscopy is being increasingly frequently used for postoperative monitoring of free flaps, offering real-time data on regional oxygen saturation and total hemoglobin index. However, comprehensive reports on Hb values and ssfree flaps using near-infrared spectroscopy analyzed the findings.<br>Methods: Eight types of free flaps were evaluated. The regional oxygen saturation and total hemoglobin index were measured in flap and normal control sites immediately after surgery and on postoperative days 1, 2, 3, 5, and 7. Measurements were taken by the surgeon or assistant. Flap viability was assessed clinically and with near-infrared spectroscopy; reoperation or other interventions were performed as necessary. Data were analyzed using a generalized linear mixed model.<br/>Results: Among 110 monitored flaps, 10 failed; of these, 4 were salvaged, 4 were partially necrotic, and 2 were completely necrotic. Causes included venous thrombus (four), arteriovenous thrombus (two), hematoma (one), and other causes (three). All failures were detected between postoperative days 1 and 4. Successful flaps showed lower regional oxygen saturation and higher total hemoglobin index values than normal controls. The difference in regional oxygen saturation was greater after the first postoperative day than immediately after surgery, while the total hemoglobin index difference remained constant. Radial forearm flaps had higher initial regional oxygen saturation and total hemoglobin index; deep inferior epigastric artery perforator flaps showed lower values throughout.<br>Conclusions: Near-infrared spectroscopy parameters vary by flap type and should be considered in postoperative monitoring. Differences between the flap and control sites, especially in total hemoglobin index, may serve as useful criteria for flap assessments.<br/>

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