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

doi:10.1055/s-0041-1732361

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

Materials Science and Engineering

Research output: Contribution to journal › Article › peer-review

10 Scopus citations

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 (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 language	English (US)
Pages (from-to)	321-327
Number of pages	7
Journal	Journal of reconstructive microsurgery
Volume	38
Issue number	4
DOIs	https://doi.org/10.1055/s-0041-1732361
State	Published - May 2022

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. M.A.P., Dr. M.R.M., and J.A.R. have a patent “Novel Wireless Probes for Tissue Perfusion Monitoring” pending. H.M.A. reports grant from National Institute of Neurological Disorders and Stroke of the National Institutes of Health under award number F31NS115422, during the conduct of the study. M.R.M. holds an equity position in Acera Surgical, Inc. and OsteoVantage, Inc., is a board member at Acera Surgical, Inc., and has received funding from ConductiveBio, Inc. M.A. P. has received research funding from Checkpoint Inc. Aside from the issues disclosed above, no authors have any actual or potential conflicts of interest related to the study matter.

Keywords

free flap
near-infrared spectroscopy
perfusion monitoring

ASJC Scopus subject areas

Surgery

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10.1055/s-0041-1732361

Cite this

Bai, W., Guo, H., Ouyang, W., Weng, Y., Wu, C., Liu, Y., Zang, H., Jacobson, L., Xu, Y., Lu, D., Hu, Z., Li, S., Arafa, H. M., Yang, Q., Westman, A. M., MacEwan, M. R., Rogers, J. A., & Pet, M. A. (2022). Intramuscular Near-Infrared Spectroscopy for Muscle Flap Monitoring in a Porcine Model. Journal of reconstructive microsurgery, 38(4), 321-327. https://doi.org/10.1055/s-0041-1732361

@article{3b029bbd81434a85abf86ddd6035e9ce,

title = "Intramuscular Near-Infrared Spectroscopy for Muscle Flap Monitoring in a Porcine Model",

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 (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.",

keywords = "free flap, near-infrared spectroscopy, perfusion monitoring",

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

year = "2022",

month = may,

doi = "10.1055/s-0041-1732361",

language = "English (US)",

volume = "38",

pages = "321--327",

journal = "Journal of reconstructive microsurgery",

issn = "0743-684X",

publisher = "Thieme Medical Publishers, Inc.",

number = "4",

}

Bai, W, Guo, H, Ouyang, W, Weng, Y, Wu, C, Liu, Y, Zang, H, Jacobson, L, Xu, Y, Lu, D, Hu, Z, Li, S, Arafa, HM, Yang, Q, Westman, AM, MacEwan, MR, Rogers, JA & Pet, MA 2022, 'Intramuscular Near-Infrared Spectroscopy for Muscle Flap Monitoring in a Porcine Model', Journal of reconstructive microsurgery, vol. 38, no. 4, pp. 321-327. https://doi.org/10.1055/s-0041-1732361

TY - JOUR

T1 - Intramuscular Near-Infrared Spectroscopy for Muscle Flap Monitoring in a Porcine Model

AU - Bai, Wubin

AU - Guo, Hexia

AU - Ouyang, Wei

AU - Weng, Yang

AU - Wu, Changsheng

AU - Liu, Yihan

AU - Zang, Hao

AU - Jacobson, Lauren

AU - Xu, Yameng

AU - Lu, Di

AU - Hu, Ziying

AU - Li, Shuo

AU - Arafa, Hany M.

AU - Yang, Quansan

AU - Westman, Amanda M.

AU - MacEwan, Matthew R.

AU - Rogers, John A.

AU - Pet, Mitchell A.

PY - 2022/5

Y1 - 2022/5

N2 - 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.

AB - 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.

KW - free flap

KW - near-infrared spectroscopy

KW - perfusion monitoring

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U2 - 10.1055/s-0041-1732361

DO - 10.1055/s-0041-1732361

M3 - Article

C2 - 34553344

AN - SCOPUS:85116146417

SN - 0743-684X

VL - 38

SP - 321

EP - 327

JO - Journal of reconstructive microsurgery

JF - Journal of reconstructive microsurgery

IS - 4

ER -

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

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