組織酸素飽和度による皮弁モニタリングの経験

抄録

The Tissue Oximeter OXY-2 is a device to measure local tissue oxygen saturation ( StO₂ ) noninvasively using near-infrared light. In the present study, we report our experience of this device in postoperative continuous flap monitoring. Seven free flaps ( gracilis flap : 2, anterolateral thigh ( ALT ) flap : 1, latissimus dorsi ( LD ) flap : 1, fibula graft : 1, toe transfer : 1, toe joint transfer : 1 ) and two pedicle flaps ( reverse posterior interosseous artery flap ( PIA ) : 1, LD island flap: 1 ) were monitored until the third postoperative morning. Eight of nine flaps survived without complications. The StO₂ values of gracilis, ALT, fibula, toe and toe joint flaps fluctuated somewhat during the first 40 hours and then subsequently stayed between 70 and 82%. Generally, the StO₂ values of the LD flaps were lower than those of the other flaps ( 50 ∼ 60% ). The PIA flap used for a child with radial ray deficiency, who had demonstrated an StO₂ value lower than 30% just after surgery, developed necrosis within 24 hours after the operation. The OXY-2 has the potential to become a useful device in flap monitoring during the postoperative period. However, special attention should be paid in mounting the oximeter probe and the cord on non-flat surfaces of the extremities.