Detection of perfusion disturbances in digit replantation using near-infrared spectroscopy and serial quantitative fluoroscopy

The Journal of Hand Surgery
Amy S ColwellHarry J Buncke

Abstract

The postoperative monitoring of digit replants continues to be a challenge. Current objective methods of digit monitoring have not been adopted widely because of their complexity or lack of sensitivity. Because tissue oxygen tension correlates directly with vascular inflow, a device that tracks changes in tissue oxygenation may be useful to monitor the perfusion and viability of digits after revascularization. A clinical study was undertaken to evaluate noninvasive monitoring of tissue oxygenation using near-infrared spectroscopy in postoperative digit replantation. Forty-eight patients were enrolled and 64 digits were monitored at 1 institute. There were 43 male and 5 female patients with an average age of 41 years (range, 13-79 y). Digits were monitored by clinical examination, fluorescein, and a tissue oximeter at 1- to 2-hour intervals for 24 to 48 hours. Sixty-one digits survived and 3 digits failed. In the surviving digits the fluorescein and tissue oxygen saturation (StO2) readings were similar to the control digit readings. There were no significant differences between fluorescein and StO2 or between StO2 readings for control and surviving digits. In the digits that failed to survive both fluorescein and StO2 readings w...Continue Reading

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Citations

May 31, 2011·Clinics in Plastic Surgery·Amy S Colwell, Randall O Craft
Dec 17, 2008·The Journal of Hand Surgery·Karim Bakri, Steven L Moran
Nov 6, 2008·The Journal of Hand Surgery·Xu ZhangHongwei Zhu
May 6, 2008·Plastic and Reconstructive Surgery·Amy S ColwellYvonne Karanas
Mar 26, 2010·Plastic and Reconstructive Surgery·Ali NajefiAra W Darzi
Jan 29, 2016·Plastic and Reconstructive Surgery·Brett T PhillipsMichael R Zenn
Aug 27, 2013·Expert Review of Medical Devices·Albert H ChaoErgun Kocak
Jul 9, 2014·Annals of Plastic Surgery·Robert F LohmanRisal Djohan

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