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J Reconstr Microsurg 2022; 38(04): 321-327
DOI: 10.1055/s-0041-1732361
Original Article

Intramuscular Near-Infrared Spectroscopy for Muscle Flap Monitoring in a Porcine Model

Wubin Bai‡   *
1   Department of Applied Physical Sciences, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
,
Hexia Guo‡   *
2   Department of Materials Science and Engineering, Querrey Simpson Institute for Bioelectronics, Northwestern University, Chicago, Illinois
3   Department of Materials Science and Engineering, Northwestern University, Evanston, Illinois
,
Wei Ouyang
2   Department of Materials Science and Engineering, Querrey Simpson Institute for Bioelectronics, Northwestern University, Chicago, Illinois
,
Yang Weng
2   Department of Materials Science and Engineering, Querrey Simpson Institute for Bioelectronics, Northwestern University, Chicago, Illinois
,
Changsheng Wu
2   Department of Materials Science and Engineering, Querrey Simpson Institute for Bioelectronics, Northwestern University, Chicago, Illinois
,
Yihan Liu
1   Department of Applied Physical Sciences, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
,
Hao Zang
2   Department of Materials Science and Engineering, Querrey Simpson Institute for Bioelectronics, Northwestern University, Chicago, Illinois
,
Lauren Jacobson
4   Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Washington University, St. Louis, Missouri
,
Yameng Xu
5   Department of Mechanical Engineering and Materials Science, Washington University, St. Louis, Missouri
,
Di Lu
2   Department of Materials Science and Engineering, Querrey Simpson Institute for Bioelectronics, Northwestern University, Chicago, Illinois
,
Ziying Hu
2   Department of Materials Science and Engineering, Querrey Simpson Institute for Bioelectronics, Northwestern University, Chicago, Illinois
,
Shuo Li
2   Department of Materials Science and Engineering, Querrey Simpson Institute for Bioelectronics, Northwestern University, Chicago, Illinois
,
Hany M. Arafa
2   Department of Materials Science and Engineering, Querrey Simpson Institute for Bioelectronics, Northwestern University, Chicago, Illinois
,
Quansan Yang
2   Department of Materials Science and Engineering, Querrey Simpson Institute for Bioelectronics, Northwestern University, Chicago, Illinois
6   Department of Mechanical Engineering, Northwestern University, Evanston, Illinois
,
Amanda M. Westman
4   Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Washington University, St. Louis, Missouri
,
Matthew R. MacEwan
7   Department of Neurosurgery, School of Medicine, Washington University, St. Louis, Missouri
,
John A. Rogers
2   Department of Materials Science and Engineering, Querrey Simpson Institute for Bioelectronics, Northwestern University, Chicago, Illinois
3   Department of Materials Science and Engineering, Northwestern University, Evanston, Illinois
6   Department of Mechanical Engineering, Northwestern University, Evanston, Illinois
8   Department of Biomedical Engineering, Northwestern University, Evanston, Illinois
9   Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
,
Mitchell A. Pet 
4   Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Washington University, St. Louis, Missouri
› Author Affiliations Funding Funding for this study was received from the Division of Plastic Surgery and the Department of Neurosurgery at Washington University, and from the Querry Simpson Institute of Bioelectronics at Northwestern University.
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Abstract

Background Current near-infrared spectroscopy (NIRS)-based systems for continuous flap monitoring are limited to flaps which carry a cutaneous paddle. As such, this useful and reliable technology has not previously been applicable to muscle-only free flaps where other modalities with substantial limitations continue to be utilized.

Methods We present the first NIRS probe which allows continuous monitoring of local tissue oxygen saturation (StO2) directly within the substance of muscle tissue. This probe is flexible, subcentimeter in scale, waterproof, biocompatible, and is fitted with resorbable barbs which facilitate temporary autostabilization followed by easy atraumatic removal. This novel device was compared with a ViOptix T.Ox monitor in a porcine rectus abdominus myocutaneous flap model of arterial and venous occlusions. During these experiments, the T.Ox device was affixed to the skin paddle, while the novel probe was within the muscle component of the same flap.

Results The intramuscular NIRS device and skin-mounted ViOptix T.Ox devices produced very similar StO2 tracings throughout the vascular clamping events, with obvious and parallel changes occurring upon vascular clamping and release. The normalized cross-correlation at zero lag describing correspondence between the novel intramuscular NIRS and T.Ox devices was >0.99.

Conclusion This novel intramuscular NIRS probe offers continuous monitoring of oxygen saturation within muscle flaps. This experiment demonstrates the potential suitability of this intramuscular NIRS probe for the task of muscle-only free flap monitoring, where NIRS has not previously been applicable. Testing in the clinical environment is necessary to assess durability and reliability.

Keywords

free flap - near-infrared spectroscopy - perfusion monitoring

* These authors contributed equally to this work.




Publication History

Received: 11 May 2021

Accepted: 31 May 2021

Article published online:
22 September 2021

© 2021. Thieme. All rights reserved.

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