دورية أكاديمية
Use of Ambient Light Compatible Fluorescence-Guided Surgical Technology for Objective Assessment of Flap Perfusion in Autologous Breast Reconstruction.
| العنوان: | Use of Ambient Light Compatible Fluorescence-Guided Surgical Technology for Objective Assessment of Flap Perfusion in Autologous Breast Reconstruction. |
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| المؤلفون: | Shaffrey EC; Division of Plastic Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin., Moura SP; Division of Plastic Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.; Boston University Chobanian and Avedisian School of Medicine, Division of Plastic and Reconstructive Surgery, Boston, Massachusetts., Seitz AJ; Division of Plastic Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin., Jupitz S; Onlume Surgical, Research Division, Madison, Wisconsin., Seets T; Onlume Surgical, Research Division, Madison, Wisconsin., Kawahara T; Onlume Surgical, Research Division, Madison, Wisconsin., Uselmann A; Onlume Surgical, Research Division, Madison, Wisconsin., Lin C; Onlume Surgical, Research Division, Madison, Wisconsin., Poore SO; Division of Plastic Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. |
| المصدر: | Journal of reconstructive microsurgery [J Reconstr Microsurg] 2024 Jun 05. Date of Electronic Publication: 2024 Jun 05. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Thieme-Stratton Country of Publication: United States NLM ID: 8502670 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1098-8947 (Electronic) Linking ISSN: 0743684X NLM ISO Abbreviation: J Reconstr Microsurg Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: [New York, N.Y.] : Thieme-Stratton, [c1984- |
| مستخلص: | Background: Decreased autologous flap vascular perfusion can lead to secondary procedures. Fluorescence angiography during surgery reduces the probability of repeat surgery but suffers from interpretation variability. Recently, the OnLume Avata System was developed, which evaluates real-time vascular perfusion in ambient light. This study aims to predict complications in autologous breast reconstruction using measures of relative intensity (RI) and relative area (RA). Methods: Patients undergoing autologous breast reconstruction underwent intraoperative tissue perfusion assessment using the OnLume Avata System. Post-hoc image annotation was completed by labeling areas of the flap interpreted to be "Well Perfused," "Questionably Perfused," and "Under Perfused." RIs and RAs were calculated for the marked areas. Primary complications of interest were overall complication rate, fat and mastectomy skin flap necrosis, and surgical revision. Logistic regression was applied to determine the odds of developing a complication based on RI and RA for each image. Results: A total of 25 patients (45 flaps) were included. In total, 17 patients (68%) developed at least one complication. Patients who developed any complication ( p = 0.02) or underwent a surgical revision for complications ( p = 0.02) had statistically lower RI of under-perfused portions of the flap. Patients with greater areas of under-perfused flap had a significantly higher risk of developing fat necrosis (odds ratio [OR]: 5.71, p = 0.03) and required a revision operation (OR: 1.10, p = 0.01). Conclusion: Image-based interpretation using the OnLume Avata System correlated with the risk of developing postoperative complications that standard fluorescence imaging systems may not appreciate. This information can benefit surgeons to improve perfusion assessment and intraoperative decision-making. Competing Interests: Disclosure The authors report no conflicts of interest in this work. (Thieme. All rights reserved.) |
| معلومات مُعتمدة: | R43CA206754 National Cancer Institute of the NIH; R44CA206754 National Cancer Institute of the NIH |
| تواريخ الأحداث: | Date Created: 20240605 Latest Revision: 20240605 |
| رمز التحديث: | 20240606 |
| DOI: | 10.1055/s-0044-1787267 |
| PMID: | 38838710 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1098-8947 |
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| DOI: | 10.1055/s-0044-1787267 |