Early recognition of ischaemia with continuous real-time tissue oxygen monitoring in head and neck microvascular flaps

Early recognition of ischaemia with continuous real-time tissue oxygen monitoring in head and... Aim of this study was to evaluate the reliability of a continuous real-time tissue oxygen monitoring method (Licox®) for postoperative follow-up of free microvascular flaps after ablative head and neck tumour surgery. We also wanted to establish and test accurate alarm levels for this monitoring method. One hundred eighteen head and neck cancer patients, operated in Tampere University Hospital, Finland, were analysed. Tissue oxygen (P ti O 2 ) levels were continuously monitored with the Licox® system. Receiver operating characteristic analysis was performed considering following alarming signals: a clear change in the trend of the curve leading to a decline more than 50% in 1 h or a decline below 10 mmHg in the P ti O 2 level. Licox® recognized all the patients who needed re-operation with sensitivity of 100% and specificity of 88%. The overall success rate was 99.2% (117 of 118) and flap salvage rate 88% (seven of eight), respectively. The Licox® tissue oxygen pressure monitoring system is a reliable method for detecting early postoperative circulation problems in free microvascular flaps. The suggested alarm signals are a clear change in the trend of the curve leading a decline more than 50% in an hour or a decline below 10 mmHg. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Plastic Surgery Springer Journals

Early recognition of ischaemia with continuous real-time tissue oxygen monitoring in head and neck microvascular flaps

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Publisher
Springer-Verlag
Copyright
Copyright © 2012 by Springer-Verlag
Subject
Medicine & Public Health; Plastic Surgery
ISSN
0930-343X
eISSN
1435-0130
D.O.I.
10.1007/s00238-011-0688-5
Publisher site
See Article on Publisher Site

Abstract

Aim of this study was to evaluate the reliability of a continuous real-time tissue oxygen monitoring method (Licox®) for postoperative follow-up of free microvascular flaps after ablative head and neck tumour surgery. We also wanted to establish and test accurate alarm levels for this monitoring method. One hundred eighteen head and neck cancer patients, operated in Tampere University Hospital, Finland, were analysed. Tissue oxygen (P ti O 2 ) levels were continuously monitored with the Licox® system. Receiver operating characteristic analysis was performed considering following alarming signals: a clear change in the trend of the curve leading to a decline more than 50% in 1 h or a decline below 10 mmHg in the P ti O 2 level. Licox® recognized all the patients who needed re-operation with sensitivity of 100% and specificity of 88%. The overall success rate was 99.2% (117 of 118) and flap salvage rate 88% (seven of eight), respectively. The Licox® tissue oxygen pressure monitoring system is a reliable method for detecting early postoperative circulation problems in free microvascular flaps. The suggested alarm signals are a clear change in the trend of the curve leading a decline more than 50% in an hour or a decline below 10 mmHg.

Journal

European Journal of Plastic SurgerySpringer Journals

Published: Jul 1, 2012

References

  • Retrospective review of 400 consecutive free flap reconstructions for oncologic surgical defects
    Disa, JJ; Hu, QY; Hidalgo, DA

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