Prediction of post-operative necrosis after mastectomy: a pilot study utilizing optical diffusion imaging spectroscopy.

World Journal of Surgical Oncology
Roshni RaoRod J Rohrich

Abstract

Flap necrosis and epidermolysis occurs in 18-30% of all mastectomies. Complications may be prevented by intra-operative detection of ischemia. Currently, no technique enables quantitative valuation of mastectomy skin perfusion. Optical Diffusion Imaging Spectroscopy (ViOptix T.Ox Tissue Oximeter) measures the ratio of oxyhemoglobin to deoxyhemoglobin over a 1 x 1 cm area to obtain a non-invasive measurement of perfusion (StO2). This study evaluates the ability of ViOptix T.Ox Tissue Oximeter to predict mastectomy flap necrosis. StO2 measurements were taken at five points before and at completion of dissection in 10 patients. Data collected included: demographics, tumor size, flap length/thickness, co-morbidities, procedure length, and wound complications. One patient experienced mastectomy skin flap necrosis. Five patients underwent immediate reconstruction, including the patient with necrosis. Statistically significant factors contributing to necrosis included reduction in medial flap StO2 (p = 0.0189), reduction in inferior flap StO2 (p = 0.003), and flap length (p = 0.009). StO2 reductions may be utilized to identify impaired perfusion in mastectomy skin flaps.

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Citations

Sep 8, 2011·Journal of Biomedical Optics·Sylvain GiouxJohn V Frangioni
May 31, 2011·Clinics in Plastic Surgery·Maurice Y Nahabedian
Mar 26, 2014·The British Journal of Surgery·S A RobertsonR I Cutress
Apr 13, 2013·International Journal of Surgery·Gustavo Henrique Fabri Pereira RibeiroRené Aloísio da Costa Vieira
May 26, 2017·Plastic and Reconstructive Surgery·Michael S ChinJanice F Lalikos
Mar 8, 2017·Journal of Wound, Ostomy, and Continence Nursing : Official Publication of the Wound, Ostomy and Continence Nurses Society·Nasir KhatriSantosh S Kale
Jul 9, 2014·Annals of Plastic Surgery·Joshua M AdkinsonRobert X Murphy
Feb 3, 2016·Annals of Plastic Surgery·Christian ReintgenBruce A Mast
Jul 8, 2011·Annals of Plastic Surgery·Ketan M PatelMaurice Y Nahabedian
Apr 13, 2013·Annals of Plastic Surgery·Cindy WuEric G Halvorson
Jul 9, 2014·Annals of Plastic Surgery·Robert F LohmanRisal Djohan
Aug 25, 2015·Plastic and Reconstructive Surgery. Global Open·Georgia C YalanisJustin M Sacks
Mar 23, 2018·Applied Spectroscopy Reviews·G Kate ParkHak Soo Choi

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Methods Mentioned

BETA
Infrared Spectroscopy
light scattering
dissection
biopsy

Software Mentioned

ViOptix
Excel

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