TY - JOUR
T1 - Postoperative Monitoring of Free DIEP Flap in Breast Reconstruction with Near-Infrared Spectroscopy: Variables Affecting the Regional Oxygen Saturation
AU - Salgarello, Marzia
AU - Rossi, Marco
AU - Pagliara, Domenico Maria
AU - Visconti, Giuseppe
AU - Barone Adesi, Liliana
PY - 2018
Y1 - 2018
N2 - Background The timing of surgical reexploration in microanastomotic thrombosis is directly related to the salvage rate of free flap. Near-infrared spectroscopy (NIRS) is a noninvasive technique, which allows a continuous bedside monitoring of flap oxygenation. The current literature is lacking in the assessment of variables able to modify the NIRS monitoring. The aim of this study is to identify patient and flap-related variables that can affect regional oxygen saturation (rSO2). Methods We retrospectively analyzed the data obtained from 45 consecutive patients undergoing breast reconstruction with deep inferior epigastric perforator (DIEP) flap. The monitoring device used is the Somanetics INVOS 5100C Cerebral/Somatic Oximeter (Covidien). Baseline measures of demographic–anthropometric variables (age, weight, height, body mass index [BMI]) and flap factors (flap size in grams, skin flap area in square centimeters, perforator number, and perforator size in millimeters) were collected from preoperative and intraoperative assessment. We investigated the linear correlation between mean rSO2and BMI, flap size, skin flap area, perforator number, and perforator size. Results A positive linear correlation between rSO2values and skin flap area, perforator number, and perforator size was found. A negative linear correlation between rSO2values and BMI and flap size was found. All correlations are statistically significant. Despite the overall negative linear correlation between rSO2values and flap size, we observed a bimodal trend: a positive relation up to 800 g, which is inverted above 800 g. Conclusion The NIRS is a reliable additional tool in free flap monitoring. A careful evaluation should be given to patient and surgery factors that can change the oximetry data.
AB - Background The timing of surgical reexploration in microanastomotic thrombosis is directly related to the salvage rate of free flap. Near-infrared spectroscopy (NIRS) is a noninvasive technique, which allows a continuous bedside monitoring of flap oxygenation. The current literature is lacking in the assessment of variables able to modify the NIRS monitoring. The aim of this study is to identify patient and flap-related variables that can affect regional oxygen saturation (rSO2). Methods We retrospectively analyzed the data obtained from 45 consecutive patients undergoing breast reconstruction with deep inferior epigastric perforator (DIEP) flap. The monitoring device used is the Somanetics INVOS 5100C Cerebral/Somatic Oximeter (Covidien). Baseline measures of demographic–anthropometric variables (age, weight, height, body mass index [BMI]) and flap factors (flap size in grams, skin flap area in square centimeters, perforator number, and perforator size in millimeters) were collected from preoperative and intraoperative assessment. We investigated the linear correlation between mean rSO2and BMI, flap size, skin flap area, perforator number, and perforator size. Results A positive linear correlation between rSO2values and skin flap area, perforator number, and perforator size was found. A negative linear correlation between rSO2values and BMI and flap size was found. All correlations are statistically significant. Despite the overall negative linear correlation between rSO2values and flap size, we observed a bimodal trend: a positive relation up to 800 g, which is inverted above 800 g. Conclusion The NIRS is a reliable additional tool in free flap monitoring. A careful evaluation should be given to patient and surgery factors that can change the oximetry data.
KW - DIEP flap
KW - NIRS monitoring
KW - Surgery
KW - variables in NIRS monitoring
KW - DIEP flap
KW - NIRS monitoring
KW - Surgery
KW - variables in NIRS monitoring
UR - http://hdl.handle.net/10807/121983
UR - http://www.thieme-connect.com/ejournals/toc/jrm
U2 - 10.1055/s-0038-1636527
DO - 10.1055/s-0038-1636527
M3 - Article
SP - 1
EP - 10
JO - Journal of Reconstructive Microsurgery
JF - Journal of Reconstructive Microsurgery
SN - 0743-684X
ER -