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

Wubin Bai, Hexia Guo, Wei Ouyang, Yang Weng, Changsheng Wu, Yihan Liu, Hao Zang, Lauren Jacobson, Yameng Xu, Di Lu, Ziying Hu, Shuo Li, Hany M. Arafa, Quansan Yang, Amanda M. Westman, Matthew R. MacEwan, John A. Rogers, Mitchell A. Pet*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


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 (StO 2) 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 StO 2 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.

Original languageEnglish (US)
Pages (from-to)321-327
Number of pages7
JournalJournal of reconstructive microsurgery
Issue number4
StatePublished - May 2022


  • free flap
  • near-infrared spectroscopy
  • perfusion monitoring

ASJC Scopus subject areas

  • Surgery


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