Tissue Oximetry Monitoring in Microsurgical Breast Reconstruction Decreases Flap Loss and Improves Rate of Flap Salvage

Abstract

The use of tissue oximetry has decreased the authors' flap loss rate and improved the flap salvage rate in microsurgical breast reconstruction. This device is a useful adjunct in flap monitoring during the postoperative period, as it may help decrease flap loss by detecting impending vascular compromise before it becomes clinically evident.

A Nationwide Analysis of the Relationship between Hospital Volume and Outcome for Autologous Breast Reconstruction

“…[21][22][23] In contrast, a policy of selective referral to high-volume centers could negatively impact the low number of autologous relative to implant reconstructions currently performed in the United States. 24 Referral to high-volume centers could paradoxically decrease autologous reconstructions by increasing the travel burden, thereby serving as a barrier to care.…”

Changes of Oxygenation and Hemoglobin-Concentration in Lower Extremity Free Flaps during Dangling

“…[9][10][11] In a large series of breast reconstruction, the use of tissue oximetry monitoring led to a reduction of the flap loss rate because of its ability to detect impeding vascular compromise before it became clinically evident. 12 Both the transcutaneous oxygen saturation (StO 2 ) and the THI were measured in a continuous fashion before, during, and after dangling. The StO 2 on the contralateral leg and on the contralateral donor site was also measured.…”

Does Increased Experience with Tissue Oximetry Monitoring in Microsurgical Breast Reconstruction Lead to Decreased Flap Loss? The Learning Effect

“…19,20 In our previous report, by Lin et al., we compared standard monitoring with our early experience on the use of tissue oximetry. 16 Although this initial experience showed great potential, it is now possible to compare outcomes based on long-term experience. In addition, in this follow-up series of patients undergoing microsurgical breast reconstruction, we assess the learning curve involved with the use of tissue oximetry and address common pitfalls based on our experience.…”

“…16 Flap compromise is often detected by near-infrared spectroscopy before any clinical signs are apparent, allowing for expeditious flap salvage. The T.Ox Tissue Oximeter (ViOptix, Inc., Fremont, Calif.) is a noninvasive monitor of real-time flap perfusion that measures scattering and absorption of calibrated wavelengths of near-infrared light, which is related to the oxygen content of hemoglobin within the monitored tissue.…”