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DOI: 10.1055/a-0916-8635
Hyperspektralimaging demonstriert mikrozirkulatorische Effekte postoperativer Ergotherapie bei Patienten mit Morbus Dupuytren
Hyperspectral imaging demonstrates microcirculatory effects of postoperative exercise therapy in Dupuytren’s diseasePublikationsverlauf
29. März 2019
03. Mai 2019
Publikationsdatum:
05. Juni 2019 (online)
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Zusammenfassung
Hintergrund Der Morbus Dupuytren (MD) ist eine häufige Bindegewebserkrankung der Hand. Um ein Rezidiv nach Eingriff zu verhindern, erhalten die Patienten in der Regel eine frühzeitige postoperative Ergotherapie (ET). Der Einfluss dieser Maßnahme auf die Durchblutungssituation und damit auf das Auftreten oder Verhindern postoperativer Komplikationen ist jedoch nicht geklärt. Das Hyperspektralimaging (HSI) erlaubt die quantitative Beurteilung der Gewebsperfusion durch Messung der Sauerstoffsättigung und des Wassergehaltes des Gewebes.
Ziel Evaluation der mikrozirkulatorischen Effekte der frühen postoperativen Ergotherapie nach partieller Fasziektomie bei MD mittels HSI zur Behandlungsoptimierung.
Patienten und Methode Die Sauerstoffsättigung und der Wassergehalt des Gewebes der Hand wurden bei fünf Patienten vor und nach 20 Minuten standarisierter ET am ersten und zweiten postoperativen Tag mittels HSI evaluiert.
Ergebnisse HSI zeigte eine qualitativ und quantitativ verbesserte Perfusion nach ET bei allen Patienten. Nach ET kam es zu einer Verbesserung der Sauerstoffsättigung um 20 % und zu einer Reduktion des Wassergehaltes um bis zu 17 %.
Schlussfolgerung HSI erlaubt die schnelle und nicht-invasive Bestimmung einer verbesserten Sauerstoffversorgung und eines erniedrigten Wassergehaltes im Gewebe des OP-Gebietes bei Patienten nach partieller Fasziektomie bei MD als Folge der ET. Dies kann die Ursache für eine verbesserte Wundheilung und reduzierte Rezidivrate sein.
Abstract
Background Dupuytren’s disease (DD) is a common connective tissue disorder of the hand. To prevent recurrence of contractures, patients usually receive early postoperative ergotherapy (ET). However, it is yet unknown how this measure impacts on local blood flow and hence on the occurrence or prevention of postoperative complications. Hyperspectral imaging (HSI) allows for a quantitative evaluation of tissue perfusion by measuring oxygen saturation and tissue water content.
Objective The aim of this work was to evaluate the microcirculatory effects of early ET after partial fasciectomy in DD using HSI for optimised treatment and prevention.
Patients and Methods In five patients, the oxygen saturation and tissue water content of the hand were measured before and 20 min after exercise therapy on the first two postoperative days using HSI.
Results HSI demonstrated improved tissue perfusion in terms of quantity and quality following ET in all patients. After ET, all patients showed a relative increase in oxygen saturation of up to 20 % and a reduction in tissue water of up to 17 %.
Conclusion HIS allows for a fast and non-invasive evaluation of increased oxygen supply and decreased tissue water content in the surgical site after partial fasciectomy in DD following postoperative exercise therapy. This may improve wound healing and decrease the rate of recurrence in DD.
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