ABSTRACT
We report a method for deriving the absolute value of absorption coefficients at depth in bilayered media. The method was simplified from that of time-resolved diffuse optical tomography (TR-DOT) into one dimension to validate and set up the main parameters with the help of simulations, and to test it in an easy preclinical model. The method was applied to buried flaps as used in reconstructive surgery, and absolute chromophore concentrations in the flap and in the upper (skin and fat) layer were derived. The encouraging results obtained lay a foundation for developing more complex multidimensional models.
ABSTRACT
BACKGROUND: Flap monitoring in reconstructive surgery is particularly important because flap failure is a dramatic event for the patient and for the medical team. Noninvasive deep tissue oxygenation monitoring is a challenge. The aim of this experimental study was to assess the performance of time-resolved near-infrared spectroscopy compared with continuous-wave near-infrared spectroscopy and with invasive oxygen partial pressure measurement in pigs. METHODS: Thirty fasciocutaneous flaps based on the superficial epigastric inferior pedicle were harvested and buried under the transcutaneous dorsal muscle (approximately 1 cm thick). An optical probe was placed on the skin above each buried flap. For each pig, two buried flaps were performed, one submitted to arterial occlusion and one to venous occlusion. Oxyhemoglobin and deoxyhemoglobin concentrations were observed for over 40 minutes before clamping, almost 20 minutes during clamping and during a period of release of approximately 20 minutes. Variations in time-resolved near-infrared spectroscopy were compared to the oxygen partial pressure and continuous-wave near-infrared spectroscopy variations. RESULTS: All vascular events were detected by the time-resolved near-infrared spectroscopy. During arterial clamping, oxyhemoglobin decreased rapidly, whereas deoxyhemoglobin increased moderately. The divergence of oxyhemoglobin and deoxyhemoglobin curves indicated arterial occlusion. During venous clamping, deoxyhemoglobin increased, whereas oxyhemoglobin increased briefly then remained stable or decreased moderately. The initial increases in the oxyhemoglobin and deoxyhemoglobin curves indicated venous occlusion. Oxygen partial pressure failed to detect vascular events in three cases. Continuous-wave near-infrared spectroscopy could not clearly identify vascular occlusions. CONCLUSIONS: Thus, the authors demonstrated the relevance of time-resolved near-infrared spectroscopy to buried flap monitoring. Time-resolved near-infrared spectroscopy could differentiate between arterial occlusion and venous occlusion.
Subject(s)
Arterial Occlusive Diseases/diagnosis , Graft Rejection/prevention & control , Monitoring, Physiologic/methods , Myocutaneous Flap/blood supply , Plastic Surgery Procedures/adverse effects , Animals , Arterial Occlusive Diseases/etiology , Arterial Occlusive Diseases/pathology , Arteries/pathology , Diagnosis, Differential , Disease Models, Animal , Graft Rejection/diagnosis , Graft Rejection/etiology , Humans , Monitoring, Physiologic/instrumentation , Myocutaneous Flap/transplantation , Oxyhemoglobins/analysis , Plastic Surgery Procedures/methods , Spectroscopy, Near-Infrared/instrumentation , Spectroscopy, Near-Infrared/methods , Sus scrofa , Veins/pathologyABSTRACT
We measured the spectrum and energy of infrared triple photons generated in a phase-matched KTiOPO4 crystal pumped by picosecond beams at 532 and 1662 nm. The experimental data are in good agreement with our model, taking into account the spectral linewidths of the incident beams as well as a parasitic Kerr effect.
