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Visible light spectroscopy bested Doppler in detecting compromised free flap perfusion

Visible light spectroscopy was noninvasive and reliable in evaluating tissue perfusion compared with hand-held Doppler and clinical examination.

Researchers hypothesized that visible light spectroscopy may be more sensitive and specific in detecting compromised free flap perfusion than previous methods.

They conducted a prospective, controlled trial of the sensitivity, specificity and accuracy of the T-Stat Model 303 VLS oximeter (Spectros Corp). Data for 68 patients with 81 flaps underwent analysis, including information on complications, reoperations, flap failures and tissue oxygen saturation. 

Results showed that 86.4% of the flaps were “either transverse rectus abdominis musculocutaneous or deep inferior epigastric artery perforator flaps,” according to the findings.

Analysis of all flaps indicated a mean tissue oxygen saturation of 56.7% (range, 39.4-72.1). Patient comorbidity or flap type did not result in significant differences for this outcome.

Three flaps required exploration for perfusion abnormality and were subsequently returned to the operating room. However, 100% of these flaps were salvaged.

Visible light spectroscopy proved to be more sensitive, specific and accurate than intermittent Doppler or clinical exam, according to the results. – by Rob Volansky

Disclosure: The researchers report no relevant financial disclosures.