Prediction of post-operative necrosis after mastectomy: a pilot study utilizing optical diffusion imaging spectroscopy.
BACKGROUND
Flap necrosis and epidermolysis occurs in 18-30% of all mastectomies. Complications may be prevented by intra-operative detection of ischemia. Currently, no technique enables quantitative valuation of mastectomy skin perfusion. Optical Diffusion Imaging Spectroscopy (ViOptix T.Ox Tissue Oximeter) measures the ratio of oxyhemoglobin to deoxyhemoglobin over a 1 x 1 cm area to obtain a non-invasive measurement of perfusion (StO2).


METHODS
This study evaluates the ability of ViOptix T.Ox Tissue Oximeter to predict mastectomy flap necrosis. StO2 measurements were taken at five points before and at completion of dissection in 10 patients. Data collected included: demographics, tumor size, flap length/thickness, co-morbidities, procedure length, and wound complications.


RESULTS
One patient experienced mastectomy skin flap necrosis. Five patients underwent immediate reconstruction, including the patient with necrosis. Statistically significant factors contributing to necrosis included reduction in medial flap StO2 (p = 0.0189), reduction in inferior flap StO2 (p = 0.003), and flap length (p = 0.009).


CONCLUSIONS
StO2 reductions may be utilized to identify impaired perfusion in mastectomy skin flaps.
Rao
Roshni
R
Department of Surgery, Division of Surgical Oncology, University of Texas, Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9155, USA. Roshni.Rao@utsouthwestern.edu
Saint-Cyr
Michel
M
Ma
Aye Moe Thu
AM
Bowling
Monet
M
Hatef
Daniel A
DA
Andrews
Valerie
V
Xie
Xian-Jin
XJ
Zogakis
Theresa
T
Rohrich
Rod
R
D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D008408:Mastectomy; D008875:Middle Aged; D009336:Necrosis; D055096:Optical Devices; D010100:Oxygen / Q000378:metabolism; D010865:Pilot Projects; D011182:Postoperative Care; D011379:Prognosis; D012867:Skin / Q000473:pathology*; D013524:Surgical Flaps / Q000473:pathology*; D015996:Survival Rate; D016896:Treatment Outcome
D010100:Oxygen